Key result
Endovascular stenting resolves delayed intestinal ischemia after total arch replacement for type A aortic dissection.
Case Report (n=1)
No
Highlights the possibility of delayed intestinal ischemia after surgery for type A aortic dissection and the effectiveness of endovascular stenting for its management.
Endovascular stenting may resolve delayed intestinal ischemia after type A dissection repair; hypothesis-generating from single case report.
We report a rare case of delayed intestinal ischemia after total arch replacement for type A acute aortic dissection. At the onset of acute aortic dissection, computed tomography (CT) angiography revealed celiac trunk occlusion and progressive dissection into the superior mesenteric artery without stenosis. However, following total arch replacement, visceral malperfusion was not detected by exploratory laparotomy. On postoperative day 12, the patient developed paralytic ileus without an elevated lactate level. CT angiography revealed new superior mesenteric artery stenosis by a thrombosed false lumen with persistent celiac trunk occlusion. Endovascular treatment including stent implantation resolved intestinal ischemia.
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Morisaki et al. (2015) conducted a case report in Type A Acute Aortic Dissection (n=1). Endovascular treatment (stent implantation and stent grafting) was evaluated on Resolution of intestinal ischemia. Endovascular treatment with stent implantation and stent grafting successfully resolved delayed intestinal ischemia following total arch replacement for type A acute aortic dissection.
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