Abstract
We had a case of recurrent Stanford type B acute aortic dissection (SBAAD) caused by endovascular aortic repair (EVAR) against abdominal aortic aneurysm. In this case, however, thoracic endovascular aortic repair (TEVAR) in combination with covered stent deployment made it possible for complete thrombosis in the false lumen after recurrence of SBAAD. A 64-year-old man complained sudden back pain. Enhanced CT examination showed SBAAD with complete thrombosis and abdominal aortic aneurysm with maximum diameter of 53 mm. EVAR was achieved at 32 days following the onset of SBAAD. Eight days after EVAR, the patient complained sudden abdominal discomfort, and enhanced CT examination showed that the false lumen was patent between distal arch and aorta just proximal of ostium of supra mesenteric artery. Furthermore, communication between true and false lumen was found in celiac artery. Three days after the recurrence of SBAAD, TEVAR was carried out for the proximal entry closure at the distal arch. In addition, 8×20 mm of Palmaz stent was deployed in celiac artery to restore blood flow in the true lumen. Four days after TEVAR, enhanced CT examination showed the residual communication into false lumen through the distal site of the stent in celiac artery. Covered stent was deployed in celiac artery for the residual entry closure 66 days after the recurrence of SBAAD. The last enhanced CT examination showed complete thrombosis in the false lumen after recurrence of SBAAD.
