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Staged hybrid single lumen reconstruction (TIGER) with bilateral subclavian transposition coupled with thoracic endovascular aneurysm repair in the management of acute symptomatic complex type B aortic dissection in a patient with arteria lusoria
  1. Sherif Sultan1,
  2. Yogesh Acharya1,
  3. Hiba Salahat2 and
  4. Niamh Hynes3
  1. 1Vascular and Endovascular Surgery, National University of Ireland Galway, Galway, Ireland
  2. 2Vascular and Endovascular Surgery, Western Vascular Institute, Galway, Ireland
  3. 3CÚRAM, National University of Ireland, Galway, Galway, Ireland
  1. Correspondence to Professor Sherif Sultan; profsherifsultan{at}icloud.com

Abstract

We present a 54-year-old Caucasian woman, who presented with acute symptomatic type B aortic dissection with deteriorating renal function. She was a known smoker with a 2-year history of dysphagia. CT angiography documented the artery of lusoria arising from the mid-thoracic aorta, aneurysmal dilation of her descending aorta, and kinetic and static flaps around her visceral ostia. The patient was managed by staged hybrid single lumen reconstruction and bilateral subclavian to carotid transpositions. During follow-up, there was no aortic rupture or retrograde type A dissection. There were no renal, visceral, cardiac, pulmonary or spinal complications. The patient went off her antihypertensive medication with a normal estimated glomerular filtration rate and accelerated aortic modulation.

  • surgery
  • vascular surgery

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Footnotes

  • Contributors SS: Conception and design, acquisition, analysis and interpretation of data, drafting the article and revising it critically for important intellectual content, and final approval. YA: Conception and design, acquisition, analysis and interpretation of data, drafting the article and revising it critically for important intellectual content, editing of figures and final approval. HS: Conception and design, acquisition, analysis and interpretation of data, drafting the article and revising it critically for important intellectual content, and final approval. NH: Conception and design, acquisition, analysis and interpretation of data, drafting the article and revising it critically for important intellectual content, and final approval.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.