{"title":"One-Stage Hybrid Surgery for Complicated Acute Type B Aortic Dissection Involving Distal Arch Aneurysm: A Case Report.","authors":"Kenji Kishita, Naoki Washiyama, Yuki Takeuchi, Masahiro Hirano, Ken Yamanaka, Yuko Ohashi, Kazumasa Tsuda, Kazuma Okamoto","doi":"10.3400/avd.cr.25-00039","DOIUrl":null,"url":null,"abstract":"<p><p>An 84-year-old woman with an acute type B aortic dissection (ATBAD), an entry tear in a distal arch aneurysm, and lower-body malperfusion underwent a hybrid approach combining total arch replacement with an elephant trunk (TAR+ET), thoracic endovascular aortic repair (TEVAR), and left renal artery stenting. This strategy avoided direct resection of the aneurysm or primary entry, yet stabilized hemodynamics and restored organ perfusion. Postoperative CT was favorable, and the patient was discharged without complications. In this elderly case of complicated ATBAD involving a distal aortic arch aneurysm, we performed TAR+ET, TEVAR, and renal artery stenting, and achieved a favorable outcome.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"18 1","pages":""},"PeriodicalIF":0.6000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12375505/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of vascular diseases","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3400/avd.cr.25-00039","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/20 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
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Abstract
An 84-year-old woman with an acute type B aortic dissection (ATBAD), an entry tear in a distal arch aneurysm, and lower-body malperfusion underwent a hybrid approach combining total arch replacement with an elephant trunk (TAR+ET), thoracic endovascular aortic repair (TEVAR), and left renal artery stenting. This strategy avoided direct resection of the aneurysm or primary entry, yet stabilized hemodynamics and restored organ perfusion. Postoperative CT was favorable, and the patient was discharged without complications. In this elderly case of complicated ATBAD involving a distal aortic arch aneurysm, we performed TAR+ET, TEVAR, and renal artery stenting, and achieved a favorable outcome.
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