Abstract
We report a successful case of thoracic endovascular aortic repair for an acute type B aortic dissection with an atherosclerotic thoracic aortic aneurysm. An 80-year-old man was admitted with acute back pain. Computed tomography showed the type B aortic dissection and the distal aortic arch aneurysm which was 75 mm in diameter. The dissection extended from the distal portion of the aneurysm and the false lumen was totally thrombosed. His symptom persisted though he was treated with antihypertensive medical therapy. Furthermore, computed tomography on 7th hospital day and 22nd hospital day were revealed the false lumen was gradually expanded. We carried out the thoracic endovascular aortic repair for the treatment of the aortic dissection and the aortic aneurysm. First, to ensure the proximal landing zone, surgical debranching was performed from the right axillary artery to the left common carotid artery and the left axillary artery. The chimney graft was inserted via the right common carotid artery. Second, to exclude the aneurysm and close the primary entry, the stent grafts were deployed from the ascending aorta to the proximal descending aorta. After deployment of proximal stent graft, the chimney graft was deployed. The postoperative course was uneventful and his symptom was disappeared. Postoperative computed tomography showed no endoleaks and expansion of the true lumen. He was discharged on the postoperative day 14.
