Treatment of delayed retrograde dissection after endovascular stenting of thoracoabdominal aortic aneurysm: graft-to-endograft anastomosis.

Background: Endovascular treatment of thoracic aortic aneurysms may be associated with procedure-related early and late complications.

Methods: We describe the case of a 70-year-old man who developed acute retrograde dissection of the ascending aorta 30 days after endovascular stent grafting of a thoracoabdominal aortic aneurysm and prior revascularization of the left subclavian artery. The ascending aorta and aortic arch were successfully replaced with a Dacron graft; the distal part of the graft was partially anastomosed to the previously placed endograft.

Conclusions: Surgical repair of dissections following a thoracic endovascular procedure is reliable with a graft-to-endograft anastomosis when native aortic tissue is not suitable.