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Title: Intimal dehiscence in the abdominal aorta following balloon fenestration for type B dissection
Authors: Maynar Moliner, Manuel 
Rostagno, R
Zander, T
Qian, Z
Llorens, R
Zerolo, I
Castaneda, WR
UNESCO Clasification: 32 Ciencias médicas
320501 Cardiología
Keywords: Intimointimal Intussusception
Circumferential Dissection
Unusual Complication
Ct Diagnosis
Tear, et al
Issue Date: 2005
Journal: Journal of Endovascular Therapy 
Abstract: Purpose: To report a case of intimal dehiscence associated with endovascular intervention in patients with aortic dissection.Case Report. A 65-year-old man presented with a type B dissection extending to the level of the common iliac arteries. Two Talent stent-grafts were placed in the descending thoracic aorta to close the entry point, but 2 lumens remained. Three days later, abdominal pain prompted another imaging session, which demonstrated a large cylindrical filling defect in the abdominal aorta ("tube-in-tube") assumed to be a partially or completely dehisced intima. Fenestration marginally improved flow to the visceral vessels, and the patient improved clinically. However, 4 days later, recurrent ischemic symptoms prompted surgery; a complete dehiscence of the aortic intima starting at the descending aorta extended to the distal abdominal aorta. The aorta was resected, but the patient died from disseminated intravascular coagulation.Conclusions: Intimal flap dehiscence associated with an endovascular procedure in the management of aortic dissection is an uncommon complication. Early detection and prompt surgical intervention of such a complication could save the patient's life. Endovascular procedures are unlikely to resolve the hemodynamic problem caused by a dehisced, distally migrated, collapsed intima.
ISSN: 1526-6028
DOI: 10.1583/04-1368.1
Source: Journal Of Endovascular Therapy [ISSN 1526-6028], v. 12 (1), p. 103-109, (Febrero 2005)
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