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Vascular and Endovascular Surgery
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Endovascular Repair of Abdominal Aortic Aneurysm With Chronic Dissection Using an Intravascular Ultrasound-Guided Reentry Catheter

Kin-Man Lai, MD

Cardiovascular Associates of Marin and San Francisco, Vascular Surgery, Larkspur, California, klai{at}camsf.com

Patrick Coleman, MD

Northern California Medical Association, Cardiology, Santa Rosa

The incidence of aortic dissection is rare (approximately 10 cases per 1 million inhabitants' year), and reports of an associated aortic dissection within an abdominal aortic aneurysm (AAA) are anecdotal. Historically, such a dissection was treated by operation, but operative risks often excluded patients from intervention. An endovascular approach appears to be more advantageous, but concerns regarding "true" versus "false" lumens and the presence of an intimal flap make an endovascular intervention potentially hazardous. In this report, the authors describe a novel endovascular repair of an AAA with an Excluder device and the successful treatment of a concomitant abdominal aortic dissection using intravascular ultrasound and a Pioneer guided reentry catheter.

Key Words: IVUS • reentry • dissection • endovascular AAA • aortic aneurysm • complication • contralateral limb occlusion

This version was published on October 1, 2008

Vascular and Endovascular Surgery, Vol. 42, No. 5, 462-465 (2008)
DOI: 10.1177/1538574408316913
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