Acute Complicated Stanford Type B Aortic Dissection with Left Renal Artery Involvement: Diagnostic Contribution of CT Angiography — A Case Report

Background: Acute Stanford type B aortic dissection requires prompt identification of complications, particularly branch-vessel involvement and malperfusion. Cross-sectional imaging defines the anatomical extent of dissection, while echocardiography provides complementary information about cardiac function and selected aortic abnormalities. Case presentation: A 59-year-old man with chronic hypertension presented to CHU Ibn Rochd with sudden interscapular pain radiating to the back, progressive dyspnea and severe hypertension (220/110 mmHg). Examination showed bilateral basal crackles without focal neurological deficits. Serum creatinine was 28 mg/L and urea 2 g/L. Electrocardiography demonstrated sinus rhythm, complete right bundle branch block and left ventricular hypertrophy. Computed tomography angiography (CTA) showed Stanford type B dissection extending from distal to the left subclavian artery to the aortic bifurcation, with partial false-lumen thrombosis and left renal artery ostial involvement with reported impaired perfusion. Bedside echocardiography reportedly showed concentric left ventricular hypertrophy and a left ventricular ejection fraction of 35%. Initial management included intravenous nicardipine, beta-blockade, analgesia, a loop diuretic and monitoring. The patient was transferred to Cheikh Khalifa International University Hospital for specialized care and was subsequently reportedly discharged. The receiving hospital discharge record was unavailable for review. Conclusion: Acute type B aortic dissection with renal artery involvement warrants urgent CTA-based anatomical assessment, hemodynamic management and specialist referral. Echocardiography can complement assessment of cardiac function. The post-transfer care and discharge status were not independently verified against the receiving hospital records.