PMC8182222_01
Preoperative reconstruction of contrast-enhanced angio-CT 3D showing the
ascending aorta, aortic arch, and descending aorta dissection.
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Three-dimensional (3D) computed tomography angiography (CTA) (Figure 1) revealed the presence of dissection flap starting on the ascending aorta, aortic arch, and descending aorta extended to the left iliac artery, with occlusion of the left common iliac artery (LCIA), the dissection flap was also extended on the SMA and left renal artery (LRA) (Figure 2).
Preoperative reconstruction of contrast-enhanced angio-CT 3D showing LCIA
occlusion, SMA dissection, and LRA occlusion.. SMA: superior mesenteric artery; LCIA: left common iliac artery; LRA: left
renal artery.
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Three-dimensional (3D) computed tomography angiography (CTA) (Figure 1) revealed the presence of dissection flap starting on the ascending aorta, aortic arch, and descending aorta extended to the left iliac artery, with occlusion of the left common iliac artery (LCIA), the dissection flap was also extended on the SMA and left renal artery (LRA) (Figure 2).
Intraoperative view of complete replacement of the ascending aorta and aortic
hemiarch with No. 30 INTERGARD Woven Vascular Graft.
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We performed the ascending aorta and the proximal aortic arch replacement with a No. 30 INTERGARD Woven Vascular Graft (Figure 3).
Angiography with evidence of the SMA obstruction by dissection fold.. SMA: superior mesenteric artery.
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The contrast agent was injected via the pigtail catheter, and it revealed a dissection flap on the first portion of SMA (Figure 4) with blood flow limitation and a dissection flap with occlusion on the left renal artery.
Postprocedural angiography of the SMA after stent placement stabilizes the
dissection fold and improved peripheral blood flow.
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The stent was carefully implanted at the ostium of the SMA, with minimal aortic protrusion (Figure 5).
Postoperative reconstruction of contrast-enhanced angio-CT 3D at 2 months
follow-up showing the INTERGARD Woven Vascular Graft in the ascending aorta,
the correct position of the stent and patency of the SMA as well as the
restoration of normal blood flow in the LCIA.. SMA: superior mesenteric artery; LCIA: left common iliac artery.
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Follow-up computed tomography (CT) examination at 2 months showed the correct position of the stent and patency of the SMA (Figure 6).