Hybrid approach with thoracic endovascular treatment and abdominal aortic replacement for acute type B aortic dissection complicated by ruptured abdominal aortic aneurysm.

The coexistence of a ruptured abdominal aortic aneurysm and acute aortic dissection is an unusual and life-threatening condition. We present the case of a patient who underwent simultaneous thoracic endovascular aortic repair and graft replacement for synchronous acute type B aortic dissection and ruptured abdominal aortic aneurysm. After deployment of the stent graft at the distal arch, graft replacement was accomplished without hemodynamic deterioration. The true lumen of the infrarenal abdominal aorta expanded, and a secure proximal anastomosis was achieved. A hybrid approach can be considered when different aortic diseases involve the same aortic lesion in an emergent setting.