Delayed visceral ischemia induced by type B aortic dissection

Abstract

Case: A 56-year-old man presented with a sudden severe abdominal pain 13 days after the onset of type B acute aortic dissection.Chest computed tomography revealed type B aortic dissection, and the true lumen was narrowed by the expanding false lumen. Blood flow through the celiac trunk, superior mesenteric artery, and left renal artery was reduced. Blood flow through the distal abdominal aorta and bilateral femoral arteries was clearly recognized. Laboratory findings such as transaminases were rapidly worsening.Outcome: The patient underwent emergency fenestration of the abdominal aorta and recovered without organ failure. Conclusions: Rapidly worsening laboratory findings led us to emergency operation with successful results. Serial monitoring of laboratory findings is the key for adequate timing of operation.

Nonocclusive mesenteric ischemia caused by type B aortic dissection: a case report

“…Reports [ 1 , 3 ] based on the data from the International Registry of Acute Aortic Dissection showed that 71 cases (7.6%) were complicated with mesenteric ischemia, and 26 cases died (36.6%) out of 1034 cases of type B aortic dissection from 1996 to 2013. Although there was no clear distinction between occlusive and nonocclusive patients in this paper, it was confirmed by other case reports that aortic dissection could cause NOMI [ 10 ].…”

Sole Obstruction of the Inferior Mesenteric Artery With Acute Aortic Dissection Causing Critical Mesenteric Ischemia

“…No current guidelines for endovascular aortic repair specially mention the risk for IMA obstruction. To our knowledge, this is the first case report of sole IMA obstruction–induced mesenteric ischemia as a complication of type B AD ( Table 1 ) ( 4 , 5 , 6 , 7 , 8 ).…”

“…(2016) ( 5 ) #3 56 M Acute type B 13 days after the onset Dynamic CA and SMA obstruction Not performed Resection of the intimal flap Kurumisawa et al. (2015) ( 6 ) #4 55 F Acute type B 5 weeks after the onset Static SMA obstruction Stenosis of the SMA Stent placement in the SMA Sasaki et al. (2019) ( 7 ) #5 41 M Acute type B At admission Dynamic SMA obstruction Stenosis of the SMA TEVAR Tshomba et al.…”