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Case Reports in Vascular Medicine
Volume 2015, Article ID 746354, 5 pages
http://dx.doi.org/10.1155/2015/746354
Case Report

Treatment with Aortic Stent Graft Placement for Stanford B-Type Aortic Dissection in a Patient with an Aberrant Right Subclavian Artery

Department of Cardiovascular Surgery, Chiba-Nishi General Hospital, 107-1 Kanegasaku, Matsudo-Shi, Chiba-ken 2702251, Japan

Received 7 April 2015; Revised 11 September 2015; Accepted 29 September 2015

Academic Editor: Paolo Vanelli

Copyright © 2015 Yohei Kawatani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 71-year-old man visited our hospital with the chief complaint of back pain and was diagnosed with acute aortic dissection (Debakey type III, Stanford type B). He was found to have a variant branching pattern in which the right subclavian artery was the fourth branch of the aorta. We performed conservative management for uncomplicated Stanford type B aortic dissection, and the patient was discharged. An ulcer-like projection (ULP) was discovered during outpatient follow-up. Complicated type B aortic dissection was suspected, and we performed thoracic endovascular aortic repair (TEVAR). The aim of operative treatment was ULP closure; thus we placed two stent grafts in the descending aorta from the distal portion of the right subclavian artery. The patient was released without complications on postoperative day 5. Deliberate sizing and examination of placement location were necessary when placing the stent graft, but operative techniques allowed the procedure to be safely completed.