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Case Reports
. 2024 Jun 5;10(5):101553.
doi: 10.1016/j.jvscit.2024.101553. eCollection 2024 Oct.

Percutaneous gluteal artery access to embolize false lumen of type B aortic dissection in marfan patient

Ada Dajci  1 , Alireza Mohseni  1 , Alessia Di Girolamo  1 , Pier Giorgio Nardis  1 , Luca di Marzo  1 , Wassim Mansour  1
Affiliations
Case Reports

Percutaneous gluteal artery access to embolize false lumen of type B aortic dissection in marfan patient

Ada Dajci et al. J Vasc Surg Cases Innov Tech. .

Abstract

This case study presents an innovative endovascular approach using percutaneous gluteal artery access for embolizing the false lumen of a type B aortic dissection in a patient with Marfan syndrome. Following multiple complex surgeries, the patient developed an enlarging thoraco-abdominal aneurysm, necessitating an urgent intervention branched endoprosthesis despite persisting false lumen perfusion. Doppler ultrasound-guided percutaneous gluteal access was utilized for spiral-coil embolization of the false lumen. Successful embolization and exclusion of the aneurism, confirmed by follow-up angiography and computed tomography scans, demonstrated the technique's efficacy and safety. This approach underscores the need for innovative solutions addressing complex vascular pathologies in patients with Marfan.

Keywords: Aortic dissection; BEVAR; Complex aortic aneurysm repair; False lumen embolization; Gluteal artery puncture; Marfan disease.

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Conflict of interest statement

None.

Figures

Fig 1
Fig 1
Preoperative computed tomography angiography (CTA) assessment of the aortic topology of the Patient. A, Aortic volume rendering reconstruction of the entire aorta; B, Volume rendering reconstruction of distal aorta showing visceral arteries origin from the true lumen; C, Axial section CTA showing a massive pleural effusion; D, Axial section CTA demonstrating the dissection of the left common iliac artery.
Fig 2
Fig 2
Preoperative (A and C) and respective postoperative (B, D, E) computed tomography angiographies (CTAs) depicting the perfusion of the false lumen (FL) through the true lumen (TL).
Fig 3
Fig 3
Postoperative computed tomography angiography (CTA) assessment of the aortic topology of the patient. A, Aortic volume rendering reconstruction of the entire aorta; B, Axial section CTA showing aneurysm shrinkage and left lung re-expansion; C, Axial section CTA showing patency of all visceral stent graft; D, Axial section CTA demonstrating patency of the aortic endograft and good embolization of the false lumen.
See this image and copyright information in PMC

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