Aortic stent grafting and side-branch embolization in an expanding chronic type B dissection

Objective: This is a report of endovascular treatment of a case of type B thoracoabdominal aortic dissection in a patient with progressive dyspnea, dorsolumbar pain, and expanding aortic diameter over a 1-year period. Methods: Pretreatment imaging evaluation showed that the false lumen supplied only the celiac trunk. Endovascular treatment combined (1) embolization of the first segment of the celiac trunk to avoid distal back-flow into the false lumen and (2) stent grafting to occlude the initial entry tear. Results: The treatment resulted in technical and clinical success. The patient remains asymptomatic 12 months after treatment. Conclusion: Stent grafting offers an interesting therapeutic alternative to exclude the initial entry tear in aortic dissection and may be combined with other endovascular procedures. (J Thorac Cardiovasc Surg 1999; 118:1021-5)