• Kosuke Narita, Koichi Akutsu, Takeshi Yamamoto, Naoki Sato, Satoru Murata, Kyoichi Mizuno, and Keiji Tanaka.
• Division of Intensive and Cardiac Care Unit, Nippon Medical School Hospital, Tokyo, Japan.
• Ann Thorac Cardiovasc Surg. 2012 Jan 1; 18 (2): 158-61.

AbstractStanford type B acute aortic dissection is sometimes complicated with compressed true lumen of the descending aorta (Dynamic obstruction) and stenosis of a major aortic branch (Static obstruction), which cause organ malperfusion. In such a case, medical therapy alone is usually not effective and endovascular treatments are required including stent implantation and balloon fenestration. However, it is difficult to determine which strategy should be selected, that is, only stent implantation at dissected branch or simultaneous fenestration with stent implantation. We report a case of a 54-year-old man with lower leg ischemia due to type B aortic dissection, who was successfully treated with stent implantation plus balloon fenestration. This case suggests that balloon fenestration plus stent implantation should be considered when static obstruction in the aortic branches is accompanied by dynamic obstruction in the descending aorta.

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