Head Vessel Reintervention Post-Type A Dissection Repair With a Hybrid Stent Prosthesis.

BACKGROUND

Adverse aortic remodeling may occur after the repair of acute type A aortic dissection (ATAAD), with branch vessel involvement being implicated due to retrograde perfusion of the false lumen (FL).

CASE SUMMARY: A 61-year-old man presented with adverse aortic remodeling following ATAAD repair with the AMDS Hybrid Prosthesis, with maximal growth in zone 2 of 9 mm over 1 year. Tears were identified in the right common carotid artery and innominate artery, which were treated with endovascular stenting. There was no further growth in zones 0 to 3 three years postprocedure.

DISCUSSION: This case demonstrates cessation in the progression of aortic degeneration following head vessel endovascular treatment. In aortic degeneration following ATAAD repair, branch vessel involvement should be considered for potential contributions to adverse remodeling.

TAKE-HOME MESSAGE: Branch vessel involvement and endovascular intervention should be considered in cases of adverse aortic remodeling following ATAAD repair, potentially reducing the need for open reintervention.