Surgical management for Stanford type A aortic dissection: direct cannulation of real lumen at the level of the Botallo's ligament by Seldinger technique.

A 50-year-old man was diagnosed with Stanford type A acute aortic dissection with cerebral malperfusion and unconsciousness. This clinical presentation was investigated by computed tomography which revealed a severe type A dissection involving all limb arteries. Successful operative treatment based on the direct arterial cannulation of the real lumen of dissected aorta at the level of Botallo's ligament by Seldinger technique achieves an appropriate perfusion and rapid cooling of the instable patient. To our knowledge this is the first reported case in the literature.