Key result
Hybrid repair successfully treats a complex type A dissection complicating an infrarenal EVAR.
Why the study?
Type A dissection is infrequently reported after infrarenal endovascular aortic repair.
Case Report (n=1)
Hybrid repair involving hemiarch repair, iliac thrombectomy, and dissection stent placement can successfully manage complex type A dissection complicating prior EVAR.
May support hybrid repair for rare type A dissection post-EVAR; leaves open need for prospective validation.
Type A dissection is infrequently reported after infrarenal endovascular aortic repair (EVAR). Here, we present a case of an EVAR with iliac branch endoprosthesis complicated by type A dissection requiring ascending arch repair. After hemiarch repair, the patient was noted to have residual type B dissection, malperfusion of the left renal artery, and compression of the EVAR with left external iliac limb occlusion. These were treated successfully with iliac thrombectomy and dissection stent placement.
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Dang et al. (2024) conducted a case report in Type A dissection after infrarenal EVAR with iliac branch endoprosthesis (n=1). Hybrid repair (hemiarch repair, iliac thrombectomy, and dissection stent placement) was evaluated on Successful treatment of residual type B dissection, malperfusion, and EVAR compression. Hybrid repair involving hemiarch repair, iliac thrombectomy, and dissection stent placement successfully treated a complex type A dissection complicating an infrarenal EVAR.
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