Successful EVAR Treatment of a Patient with Ruptured Abdominal Aortic Aneurysm Coexisting with Stanford Type B Acute Aortic Dissection

Abstract

Aortic dissection combined with aortic aneurysm is not uncommon. However, an acute aortic dissection and a ruptured aortic aneurysm rarely occur together; therefore, there is no established treatment strategy. A 90-year-old man complained of abdominal pain. Contrast-enhanced computed tomography (CT) showed a Stanford type B acute aortic dissection and ruptured abdominal aortic aneurysm. The aortic dissection had an entry in the descending thoracic aorta and a false lumen extending from the distal aortic arch to the external iliac artery, with localized extravasation of contrast medium from the false lumen of the abdominal aortic aneurysm. Emergency endovascular aortic repair was performed, and completed without any apparent endoleak. The patient was treated conservatively for Stanford type B acute aortic dissection post-surgery and discharged 34 days postoperatively. Follow-up CT demonstrated a decrease in the diameter of the abdominal aortic aneurysm and remodeling of the false lumen.