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Endovascular correction of a distal re-entry in an abdominal aorta dissection

^a Division of Vascular Surgery, Thorax Institute, Hospital Clinic, Villarroel 170, 08036, Barcelona, Spain
^b Division of Interventional Radiology, Hospital Clinic, University of Barcelona, Barcelona, Spain

*Corresponding author. Tel.: +34 932275515; fax: +34 932275749.

E-mail address: vriambau{at}clinic.ub.es (V.A. Riambau).

The re-entries are still a problem for the endovascular treatment of aortic dissections. A 60-year-old man was treated for an abdominal aortic dissection using aortic monoiliac endograft until the left iliac external artery and a femoro-femoral bypass with occlusion of the right common iliac artery and the left hypogastric artery. In his third year of follow-up, a re-entry tear in the right hypogastric ostium was diagnosed with pressurization of the aortic and common iliac aneurysmatic sac, that required correction. A self-expandable covered stent in a ‘U’ configuration was implanted, connecting the right external and internal iliac arteries, with preservation of the pelvic circulation, and exclusion of the aneurysmatic sac. In conclusion, the use of a flexible stent graft is a safe alternative, and simplifies some procedures in complex circumstances.

Key Words: Dissection; Abdominal aorta; Re-entry tear; Covered stent; Hypogastric artery; Pelvic circulation