This case illustrates the feasibility and effectiveness of percutaneous balloon fenestration and endovascular renal artery stenting for Type B acute aortic dissection with associated renal ischemia. Percutaneous balloon fenestration and endovascular stent placement should be considered as an alternative to traditional surgical approaches to restore blood flow to arteries compromised by acute aortic dissection.
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References
1.
1. Cambria RP, Brewster DC, Gertler J, et al: Vascular complications associated with spontaneous aortic dissection. J Vasc Surg7:199-209, 1988.
2.
2. Fann JI, Sarris GE, Mitchell RS, et al: Treatment of patients with aortic dissection presenting with peripheral vascular complications. Ann Surg212:705-713, 1990.
3.
3. Fann JI, Miller DC: Aortic dissection. Ann Vasc Surg9:311-323, 1995.
4.
4. DeBakey ME, McCollum CH, Crawford ES, et al: Dissection and dissecting aneurysms of the aorta: Twenty-year follow-up of 527 patients treated surgically. Surgery92:1118-1134, 1982.
5.
5. Miller DC, Mitchell RS, Oyer PE, et al: Independent determinants of operative mortality for patients with aortic dissections. Circulation70 (suppl I): 153-164, 1984.
6.
6. Jex RK, Schaff HV, Piehler JM, et al: Early and late results following repair of dissections of the descending thoracic aorta. J Vasc Surg3:226-237, 1986.
7.
7. Williams DM, Brothers TE, Messina LM: Relief of mesenteric ischemia in type III aortic dissection with percutaneous fenestration of the aortic septum. Radiology174:450-452, 1990.
8.
8. Saito S, Arai H, Kim K, et al: Percutaneous fenestration of dissecting intima with a transseptal needle. A new therapeutic technique for visceral ischemia complication acute aortic dissection. Cathet Cardiovasc Diagn26:130-135, 1992.
9.
9. Faykus MH Jr, Hiette P, Koopot R: Percutaneous fenestration of a type I aortic dissection for relief of lower extremity ischemia. Cardiovasc Intervent Radiol15:183-185, 1992.
10.
10. Kato N, Sakuma H, Takeda K, et al: Relief of lower extremity ischemia with percutaneous fenestration of intimal flap in a patient with type III aortic dissection: A case report. Angiology44:755-759, 1993.
11.
11. Cowling MG, Redwood D, Buckenham TM: Case report: Critical lower limb ischaemia due to aortic dissection relieved by percutaneous transfemoral fenestration. Clin Radiol50:654-657, 1995.
12.
12. Farber A, Gmelin E, Heinemann M: Transfemoral fenestration and stent implantation in aorto-iliac dissection. Vasa24:389-391, 1995.
13.
13. Peterson AH, Williams DM, Rodriguez JL, et al: Percutaneous treatment of a traumatic aortic dissection by balloon fenestration and stent placement. AJR164:1274-1276, 1995.
14.
14. Park JH, Chung JW, Cho YK, et al: Percutaneous fenestration of aortic dissection: Salvage of an ischemic solitary kidney. Cardiovasc Intervent Radiol20:146-148, 1997.
15.
15. Yamaguchi T, Seto Y, Kuroki K, et al: Percutaneous fenestration of type B aortic dissection for decompression of false lumen pressure: Case report. Radiat Med16:145-148, 1998.
16.
16. Reber D, Aebert H, Manke M, et al: Percutaneous fenestration of the aortic dissection membrane in malperfusion syndrome. Eur J Cardiac Thorac Surg15:91-94, 1999.
17.
17. Leeser DB, Kagan SA, Ball DS: Multidisciplinary treatment of complicated aortic dissection: Combined endovascular and surgical intervention. A case report. Vascular Surgery33:623-632, 1999.
18.
18. Walker PJ, Dake MD, Mitchell RS, et al: The use of endovascular techniques for the treatment of complications of aortic dissection. J Vasc Surg18:1042-1051, 1993.
19.
19. Slonim SM, Nyman U, Semba CP, et al: Aortic dissection: Percutaneous management of ischemic complications with endovascular stents and balloon fenestration. J Vasc Surg23:241-253, 1996.
20.
20. Slonim SM, Miller DC, Mitchell RS, et al: Percutaneous balloon fenestration and stenting for life-threat-ening ischemic complications in patients with acute aortic dissection. J Thorac Cardiovasc Surg117:1118-1127, 1999.
21.
21. Williams DM, Lee DY, Hamilton BH, et al: The dissected aorta: Percutaneous treatment of ischemic complications-principles and results. J Vasc Intervent Radiol8:605-625, 1997.
22.
22. Chavan A, Hausmann D, Dresler C, et al: Intravascular ultrasound-guided percutaneous fenestration of the intimal flap in the dissected aorta. Circulation96:2124-2127, 1997.
