Endovascular stent graft treatment for stenosis in isolated infrarenal abdominal aortic dissection: A case report

Abstract

We report a case of complicated isolated infrarenal abdominal aortic dissection (IAAD) that was treated with stent graft. A 79-year-old man presented with acute bilateral lower limb pain. A contrast-enhanced CT performed 2 h later revealed sever stenosis of infrarenal abdominal aorta due to IAAD. Angiography identified a primary tear just below the upper end of the IAAD. A smaller stent graft was placed distally to avoid stent graft-induced new entry, and a large stent graft was placed proximally to cover the primary entry. The stenosis improved immediately after the procedure, and pain relief was achieved. Stent graft placement for entry closure appeared to be an effective for IAAD.

Keywords: IAAD; stenosis; stent graft.

Figure 1.

(a) Axial preoperative contrast-enhanced CT imaging showed severe stenosis of the abdominal aorta due to aortic dissection (arrow). (b) Coronal preoperative contrast-enhanced CT imaging showed dissection extending from the infrarenal abdominal aorta to the bilateral iliac arteries. The true lumen (arrow) was compressed by the false lumen.

Figure 2.

(a) Angiography performed from the true lumen showed the primary entry tear just below the top of the aortic dissection (arrow). (b) After placement of the stent graft, the angiography showed that the false lumen had disappeared, and the true lumen had dilated. (c) Contrast-enhanced CT performed 2 days after the endovascular treatment showed shrinkage and thrombosis of the false lumen.