PMC5850994_01
Preoperative chest X-ray without abnormal finding
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On chest X-ray, there was no abnormal finding (Figure 1).
Contrast-enhanced computed tomography scan showing Stanford type B aortic dissection.
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Contrast-enhanced computed tomography scan revealed Stanford type B aortic dissection from descending thoracic aorta to iliac arteries (Figure 2).
Contrast-enhanced computed tomography scan showing malperfusions of left kidney (white arrow) and left iliac artery (blue arrow)
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Despite medical treatment with labetalol (120mg/h) and nicardipine (2.5mg/h), lower limb ischaemia and acute renal failure developed due to malperfusion at HAD #2 (Figure 3).
Venous cannulations for extracorporeal life support under fluoroscopic guidance. A 21 French venous cannula was inserted into the right common femoral vein for venous drainage (white arrow). A 17 French arterial cannula was inserted into the left common femoral vein for return (blue arrow).
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All procedures were done percutaneously with fluoroscopic guidance (Figure 4).
Malperfusions of left kidney and left iliac artery were resolved after operation at POD#14.
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Malperfusions of left kidney and left iliac artery were resolved and there was no abnormal finding of lung parenchyma and pulmonary vessels on contrast-enhanced computed tomography scan at POD#14 (Figure 5).