Kurimoto Yoshihiko, Morishita Kiyofumi, Kawaharada Nobuyoshi, Osawa Hisayoshi, Maeda Toshiyuki, Higami Tetsuya, Asai Yasufumi
Department of Traumatology and Critical Care Medicine, Sapporo Medical University, South 1 West 16, Chuo-ku, Sapporo 060-8543, Japan.
Ann Vasc Surg. 2007 Jul;21(4):515-8. doi: 10.1016/j.avsg.2006.10.018. Epub 2007 Mar 27.
Generally, extra-anatomical bypass grafting has been chosen for patients with leg ischemia secondary to acute aortic dissection. However, these patients are high-risk candidates for visceral vessel compromise as well. We present a case of leg ischemia secondary to acute aortic dissection, which was able to be treated by immediate stent-grafting. A 58-year-old male was transferred to our hospital for acute right-leg ischemia. Computed tomography revealed partial infarction of right kidney and severely compressed true lumen of abdominal aorta. Emergency endovascular stent-grafting was chosen to consider possible visceral vessel compromises instead of contemporary bypass grafting for leg ischemia. Pulsation of the right femoral artery was immediately achieved following stent-grafting. Primary entry closure using a Stent graft could be a treatment of choice for complications due to acute aortic dissection.