The case was forty years old man with Marfan syndrome. The right subclavian artery aneurysm after total aortic repair was treated with the hybrid operation consisting of endovascular treatment and surgical treatment. After coil embolization of the branch of subclavian artery aneurysm, common carotid artery was exposed. The stentgraft was deployed from brachiocephalic artery to common carotid artery. The subclavian artery was exposed by supraclavian approach, a bypass surgery (right common carotid artery–subclavian artery bypass) was done with T synthetic graft. The postoperative complication had not occurred and the patient was discharged after 11th hospital day.
A 58-year-old man presented with chronic type B aortic aneurysm with three-channeled dissection on CT scan. He previously underwent thoracic endovascular aortic repair for complicated acute type B aortic dissection. As the aneurysm was dilated without false lumen thrombosis and his symptoms indicated impending rupture, we performed false lumen embolization using the Candy plug technique. Postoperative and follow-up imaging revealed a completely thrombosed false lumen with a reduced diameter. The Candy plug technique proved useful for the treatment of chronic aortic dissection.
We report two cases of the successful emergent thoracic endovascular aortic repair (TEVAR) for Stanford type B acute aortic dissection (TBAD). Case 1: Computed tomography in a 55-years-old man, showed severe stenosis of the true lumen, and laboratory data demonstrated ischemia of multiple organs. TEVAR was successfully performed, but the patient required continuous hemofiltration and temporary hemodialysis. Case 2: A 67-year-old woman underwent successful emergent TEVAR for a ruptured TBAD. Emergent TEVAR is very effective for the treatment of severe complicated TBAD. However, further improvements to patient transport, earlier optimal devise transport are needed.