Journal List > J Korean Soc Radiol > v.64(3) > 1086907

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Cho, Byun, Kim, and Kim: Percutaneous Fenestration and Stent Placement for Aortic Dissection that Relieved Occluded Infrarenal Abdominal Aortic Flow: A Case Report
Interventional Radiology
Case Report

Journal of the Korean Society of Radiology 2011; 64(3): 239-243.

Published online: 31 March 2011

DOI: https://doi.org/10.3348/jksr.2011.64.3.239

Percutaneous Fenestration and Stent Placement for Aortic Dissection that Relieved Occluded Infrarenal Abdominal Aortic Flow: A Case Report

Eui-Min Cho, M.D., Joo Nam Byun, M.D., Dong Hun Kim, M.D.2, Yong Jae Kim, M.D.3

1Department of Radiology, Chosun University Hospital, Korea.

2Department of Radiology, Soonchunhyang University Hospital Bucheon, Korea.

3Department of Radiology, Soonchunhyang University Hospital, Korea.

Address reprint requests to: Dong Hun Kim, M.D., Ph.D., Department of Radiology, Soonchunhang University Hospital Bucheon, 1174, Jung-dong, Wonmi-gu, Bucheon, Gyeonggi-do 420-853, Korea. Tel. 82-32-621-5851, Fax. 82-32-621-5874, dhk0827@schmc.ac.kr

Received 23 May 2010       Accepted 24 November 2010

Copyright © 2011 The Korean Society of Radiology

Abstract

Here we report a case of infrarenal abdominal aortic occlusion secondary to Stanford type A acute aortic dissection, which was successfully treated with percutaneous fenestration and aortic stent placement. Adequate flow to the occluded infrarenal abdominal aorta was not restored by means of percutaneous fenestration alone, so an additional procedure, aortic stent placement, was required to buttress the true lumen and fenestra. We discuss ischemic complications of aortic dissection and related percutaneous intervention and review the literature.

Keywords: Aneurysm, Dissecting, Stenting

Figures and Tables

Fig. 1

A 61-year-old female with aortic dissection (Stanford type A).

A. Sagittal maximal intensity projection (MIP) scan with contrast enhancement shows dissection flap involving ascending and descending thoracic aorta (Stanford type A).
B. Coronal scan with contrast enhancement shows dissection flap and non-enhanced infrarenal abdominal aorta presenting total occlusion (arrow). However, small enhancing mesenteric vessels are seen.
C. Abdominal aortography performed from the descending thoracic aorta shows both renal arteries. Catheterizations of the true (arrow) and false (arrowheads) lumen through the right and left common femoral artery respectively are seen.
D. The fenestra at the infrarenal abdominal aorta is inflated with a 14-mm balloon catheter.
E. Occluded infrarenal abdominal aortic flow is relieved after stent (22/60-mm Wall stent, Boston Scientific, Tokyo, Japan) placement in the true lumen.
F. Coronal CT scan with contrast enhancement after intervention shows sufficent blood flow in the infrarenal abdominal aorta and both iliac arteries with well enhanced cortexes of both kidneys.
jksr-64-239-g001

References

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