In 10 patients who had been suffering from uncomplicated type B aortic dissection, TEVAR was performed to close entry with supra-aortic bypass in 7 patients. In all patients, closure of entry tear was confirmed until 3 months after TEVAR with the thrombosed occlusion and shrinkage of false lumen and the expansion of true lumen. However, complete thrombosis of false lumen has not been observed under the level of stent graft placement.
The patient was a 51-year-old woman who was admitted to a nearby hospital because of exertional dyspnea since 10 days prior. Transthoracic echocardiography revealed a mobile mass prolapsing through the tricuspid valve and right ventricular overload. Computed tomography showed a large amount of thrombi in both main pulmonary arteries. The diagnosis was submassive pulmonary thromboembolism (PTE) with right heart thrombi (RHT), and she was referred to our hospital. Thrombolytic therapy was performed under continuous echocardiographic monitoring and confirmed complete lysis of the RHT within 22 minutes. Submassive PTE with RHT was successfully treated with thrombolytic therapy during continuous echocardiographic monitoring.
An 80-year-old man presented with a 2-month history of upper abdominal pain. The serum level of IgG4 was normal range, and PR3-ANCA was elevated. Enhanced computed tomography (CT) demonstrated a supra-renal abdominal aortic aneurysm (AAA), so-called mantle sign. The maximal diameter was 45 mm. Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) revealed intensive FDG uptake in the anterior-lateral wall of AAA. After a diagnosis of inflammatory AAA, he was started on 40 mg/day of oral prednisolone instead of surgical removal. Repeat PET/CT findings after 4 weeks of treatment demonstrated regression of wall thickening and markedly decreased FDG uptake.