ABSTRACT
INTRODUCTION: A case of malperfusion in which the patient presented with aortic dissection is presented. PRESENTATION OF CASE: A 69-year-old man with an acute aortic dissection (Stanford type B) had lower limb ischemia. Axillary-femoral bypass was performed, and his lower limb ischemia improved. Eight months after the onset of acute aortic dissection, he again had lower limb ischemia. Contrast-enhanced computed tomography showed axillary-femoral bypass occlusion and true lumen collapse, compressed by the increased false lumen pressure in the aorta. Thoracic endovascular aortic repair (TEVAR) was performed for entry closure. His lower limb ischemia was improved by TEVAR. DISCUSSION: One of the complications of type B aortic dissection is malperfusion. Endovascular therapy is a first step in treating the malperfusion of type B aortic dissection. It is important to seal the entry for the treatment of malperfusion. CONCLUSION: If there is an entry, it is important to seal it for the treatment of malperfusion.
ABSTRACT
An 88-year-old man was admitted with general fatigue. Computed tomography (CT) showed a descending aortic aneurysm. The laboratory data indicated severe infection. Despite negative blood cultures, broad-spectrum intravenous antibiotic therapy was started. Though antibiotic therapy was continued for about 2 weeks, the aneurysm extended 20 mm. Thoracic endovascular aortic repair was performed, and antibiotic therapy was continued for 4 weeks after the procedure, followed by oral antibiotics for 1 year. CT showed regression of the aneurysm 15 months after reconstruction. Antibiotic therapy, preoperatively and postoperatively, is important for a mycotic aortic aneurysm.