Type B aortic dissection after endovascular aneurysm repair (EVAR) is a rare late complication and may cause rupture of a previously stable abdominal aortic aneurysm (AAA). A 79-year-old male developed acute Stanford type B aortic dissection 12 years after EVAR, with distal extension into an infrarenal AAA resulting in rupture and circulatory collapse. A large primary entry tear was located in the descending thoracic aorta. Emergency thoracic endovascular aortic repair (TEVAR) was performed to seal the entry tear, achieving rapid hemodynamic stabilization without abdominal intervention. This case suggests that AAA rupture secondary to acute type B aortic dissection after EVAR can be managed with TEVAR alone in selected acute settings.
Takahashi et al. (Thu,) studied this question.