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Management of Acute Uncomplicated Stanford B Aortic Dissection in The Era of Endovascular Repair: A Case Report

Heart Science Journal · Vol. 1 No. 3 (2020) · hlm. 36–40

DOI
10.21776/ub.hsj.2020.001.03.8
ISSN
2721-9984, 2721-9976
Terbit
2020-10-25
Penerbit
Universitas Brawijaya
Bahasa
en

Abstrak

Introduction:Uncomplicated type B aortic dissections have been traditionally treated with medication therapy. While it may provide good short-term results, longterm prognosis may be less favorable. With improvements in endovascular repair and the potential risk of disease progression, thoracic endovascular aortic repair (TEVAR) has been considered inpatients with uncomplicated type B aortic dissection. We present the case of 78-year-old gentleman who presented with acute uncomplicated type B aortic dissection managed by endovascular repair Case illustration:A 78 year-old hypertensive patient admitted to the hospital with persistent chest discomfort and cough for 2 weeks. The CT aortic angiogram showed type B dissection. Based on the recent guidelines, TEVAR should be considered in patients with uncomplicated type B aortic dissection, thus we prepared the patient for TEVAR procedure. First we established multidisciplinary vascular team for the pre-procedural preparation of the patient. We perform careful measurement through detailed CT angiography reconstruction from carotid to femoral arteries. We found proximal diameter was 30-35mm, distal diameter was 23mm and landing zone right after left brachial ostium, suitable for stent graft Valiant Captivia 36-32x150mm. The CT also showed that both femoral artery were normal, we decided to use right femoral artery as the access. We proceed to the procedure 2 days later, under general anaesthesia, digital subtraction angiography revealed dissection of descending aorta, and selected device was inserted. Subsequent contrast injection revealed total occlusion of the false lumen. Patient was transferred to ICU for postprocedural care, and extubated the day after. The hospital stay was uneventful, and one-month follow up CT shows no endoleak. Conclusion:Management of uncomplicated Stanford B dissections is very challenging. TEVAR has emerged as an alternative to surgery with lower morbidity and mortality rates that might offer good long-term results.Â

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Mohammad Saifur RohmanAfiliasi tidak diketahui49
Cholid Tri TjahjonoAfiliasi tidak diketahui37
Anna Fuji RahimahAfiliasi tidak diketahui33
Ardian RizalAfiliasi tidak diketahui28
Indra PrasetyaAfiliasi tidak diketahui23
Setyasih AnjarwaniAfiliasi tidak diketahui22
Heny MartiniAfiliasi tidak diketahui14
Yoga WaranugrahaAfiliasi tidak diketahui7
Muhammad Rizki FadlanAfiliasi tidak diketahui6
Seprian WidasmaraAfiliasi tidak diketahui5
Dea Arie KurniawanAfiliasi tidak diketahui5
Imam Mi'raj SuprayogaAfiliasi tidak diketahui5
Adhika Prastya WikanandaAfiliasi tidak diketahui4
Sawitri SatwikajatiAfiliasi tidak diketahui4
Dyah Ayu IkeningrumAfiliasi tidak diketahui4
Teguh AryanugrahaAfiliasi tidak diketahui4
Krishna Ari NugrahaAfiliasi tidak diketahui4
Dadang HendrawanAfiliasi tidak diketahui3
Harris KristantoAfiliasi tidak diketahui3
Lutfi Hafiz ZunardiAfiliasi tidak diketahui3
Dedy IrawanAfiliasi tidak diketahui3
Liemena Harold AdrianAfiliasi tidak diketahui3
Ayu Asri Devi AdityawatiAfiliasi tidak diketahui3
Imelda KrisnasariAfiliasi tidak diketahui3
Wella KarolinaAfiliasi tidak diketahui3
Bayu AjiAfiliasi tidak diketahui3
Eko Sakti PramukantoroUniversity of Brawijaya2
Kasyful AmronUniversity of Brawijaya2
Viera WardhaniUniversity of Brawijaya2
Tonny AdriyantoAfiliasi tidak diketahui2
Irma KameliaAfiliasi tidak diketahui2
Oktafin Srywati PamunaAfiliasi tidak diketahui2
Anita Surya SantosoAfiliasi tidak diketahui2
Ratna PancasariAfiliasi tidak diketahui2
Aloysius Yuwono SupraptaAfiliasi tidak diketahui2

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Sumber metadata: OAI-PMH (metadata jurnal) https://heartscience.ub.ac.id/index.php/heartscience/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en">Management of Acute Uncomplicated Stanford B Aortic Dissection in The Era of Endovascular Repair: A Case Report</dc:title>
	<dc:creator xml:lang="en">Kamila, Putri Annisa</dc:creator>
	<dc:creator xml:lang="en">Kurnianingsih, Novi</dc:creator>
	<dc:creator xml:lang="en">Widito, Sasmojo</dc:creator>
	<dc:creator xml:lang="en">Sargowo, Djanggan</dc:creator>
	<dc:creator xml:lang="en">Satrijo, Budi</dc:creator>
	<dc:subject xml:lang="en">Critical limb ischemia</dc:subject>
	<dc:subject xml:lang="en">Endovascular stenting</dc:subject>
	<dc:subject xml:lang="en">Superficial femoral artery</dc:subject>
	<dc:description xml:lang="en">Introduction:Uncomplicated type B aortic dissections have been traditionally treated with medication therapy. While it may provide good short-term results, longterm prognosis may be less favorable. With improvements in endovascular repair and the potential risk of disease progression, thoracic endovascular aortic repair (TEVAR) has been considered inpatients with uncomplicated type B aortic dissection. We present the case of 78-year-old gentleman who presented with acute uncomplicated type B aortic dissection managed by endovascular repair Case illustration:A 78 year-old hypertensive patient admitted to the hospital with persistent chest discomfort and cough for 2 weeks. The CT aortic angiogram showed type B dissection. Based on the recent guidelines, TEVAR should be considered in patients with uncomplicated type B aortic dissection, thus we prepared the patient for TEVAR procedure. First we established multidisciplinary vascular team for the pre-procedural preparation of the patient. We perform careful measurement through detailed CT angiography reconstruction from carotid to femoral arteries. We found proximal diameter was 30-35mm, distal diameter was 23mm and landing zone right after left brachial ostium, suitable for stent graft Valiant Captivia 36-32x150mm. The CT also showed that both femoral artery were normal, we decided to use right femoral artery as the access. We proceed to the procedure 2 days later, under general anaesthesia, digital subtraction angiography revealed dissection of descending aorta, and selected device was inserted. Subsequent contrast injection revealed total occlusion of the false lumen. Patient was transferred to ICU for postprocedural care, and extubated the day after. The hospital stay was uneventful, and one-month follow up CT shows no endoleak. Conclusion :Management of uncomplicated Stanford B dissections is very challenging. TEVAR has emerged as an alternative to surgery with lower morbidity and mortality rates that might offer good long-term results. </dc:description>
	<dc:publisher xml:lang="en">Universitas Brawijaya</dc:publisher>
	<dc:date>2020-10-25</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://heartscience.ub.ac.id/index.php/heartscience/article/view/85</dc:identifier>
	<dc:identifier>10.21776/ub.hsj.2020.001.03.8</dc:identifier>
	<dc:source xml:lang="en">Heart Science Journal; Vol. 1 No. 3 (2020): Management of Coronary Artery Disease: From Risk Factors to The Better Long-Term Outcomes; 36-40</dc:source>
	<dc:source>2721-9984</dc:source>
	<dc:source>2721-9976</dc:source>
	<dc:source>10.21776/ub.hsj.2020.001.03</dc:source>
	<dc:language>en</dc:language>
	<dc:relation>https://heartscience.ub.ac.id/index.php/heartscience/article/view/85/320</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2020 Brawijaya Cardiovascular Research Centre</dc:rights>
</oai_dc:dc>