2023 Volume 32 Issue 1 Pages 31-35
A 57-year-old female developed type B acute aortic dissection 13 years ago and had been observed without complications. Two years ago, she developed type A acute aortic dissection, and underwent ascending aortic replacement and thoracic endovascular aortic repair (TEVAR) for the ulcer-like projection (ULP) lesion that appeared in the descending thoracic aorta. One year ago, multiple peripheral embolisms derived from a false lumen occurred in the left limb and buttocks, and the dissecting aortic aneurysm was also enlarged. The dissection extended from the descending thoracic aorta to the left external iliac artery, and visceral arteries were perfused in the true lumen. The residual entry was located at the proximal of where the celiac artery branches and the re-entry was located before the bifurcation of the internal iliac artery of the left common iliac artery. The left internal iliac artery was perfused from the false lumen. The left femoral artery was punctured, the left internal iliac artery was embolized via the re-entry of the left common iliac artery, and the entry and re-entry were closed by stent grafts. After the operation, the false lumen became complete thrombosis, and one year has passed since the operation, but no enlargement of the aortic diameter has been observed.
