Abstract
We report a 71-year-old man with a sudden onset severe back and abdominal pain who had a Stanford type B acute aortic dissection extending through a preexisting 78 mm abdominal aortic aneurysm that was diagnosed by computed tomography scan in a prior hospital. He was transferred to our hospital by an ambulance. There was no evidence of aortic rupture, but a continuous abdominal pain. Though the patient was diagnosed an impending rupture of an abdominal aortic aneurysm, he was strictly treated with antihypertensive medication waiting to stabilize intimal flap prior to a repair of the abdominal aortic aneurysm. Open fenestration and bifurcated graft replacement were performed at 10th day from the onset. Proximal side of the graft was anastomosed to both true and false lumina what was called double barrel anastomosis. It was thought to be an inflammatory aneurysm through the clinical course and the pathological findings. There were no postoperative complications. The patient was discharged with ambulatory state at 19th postoperative day.
