Retrograde Ascending Aortic Dissection after Stent Grafting for Stanford Type B Aortic Dissection with Severe Limb Ischemia

Figures

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  Fig. 1 Computed tomography showed acute Stanford type B aortic dissection (a, b). The dissection entry was found on the aortic arch just distal to the left subclavian artery orifice. The true lumens of the bilateral common iliac arteries were compressed by the thrombosed false lumen (c, d; arrow). There were no other organ malperfusions. The diameters of the ascending aorta, aortic arch, and descending aorta were 33, 28, and 30 mm, respectively (average diameter of the true lumen was 21.7 mm).

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  Fig. 2 Computed tomography 2 days after the procedure showed that TEVAR was successful, resulting in expansion and patency of the true lumen with no endoleak (a, b).

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  Fig. 3 Emergency computed tomography 10 days after TEVAR revealed retrograde Stanford type A aortic dissection (rAAD) involving the ascending aorta and aortic arch (a). The entry of rAAD was on the greater curvature of the aortic arch just proximal to the previous stent graft (b, c, arrow). Distal anastomosis was made to the aortic arch and the previous stent graft was involved in the distal anastomosis (d).