Chan SM, Brahmandam A, Cardella JA, Elefteriades J, Setaro JF, Mangi AA, Ochoa Chaar CI. Aortic remodeling and competitive flow after surgical treatment of aortic dissection.
JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2021;
7:404-407. [PMID:
34278070 PMCID:
PMC8261546 DOI:
10.1016/j.jvscit.2021.05.009]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/06/2021] [Indexed: 11/17/2022]
Abstract
Aortic remodeling after dissection is poorly understood and remains a focus of current research. In the present report, we have described the cases of two patients with acute lower extremity ischemia related to malperfusion from aortic dissection treated with extra-anatomic axillobifemoral bypass. During long-term follow-up, aortic remodeling led to reinstitution of flow through the native aorta. This resulted in competitive flow, leading to complete thrombosis of the extra-anatomic conduits. These cases highlight the occurrence of spontaneous aortic recanalization and subsequent competitive flow, two vascular phenomena that are not well understood but can significantly affect patient outcomes.
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