CTICasesChronic Type B Aortic Dissection with Renal Malperfusion
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Imaging findings
CT angiogram in a young patient with Marfan syndrome demonstrates a type B aortic dissection with a slit-like, near-completely collapsed true lumen. The right renal artery is compromised, leading to an atrophic right kidney. Post-stenting CT shows successful expansion and reinflation of the true lumen and improved perfusion to the abdominal organs, with thrombus formation in the now-stagnant false lumen.
Key takeaways
Stenting chronic type B aortic dissections is challenging because the dissecting membrane becomes fibrotic and endothelialized over time, resisting expansion. However, endovascular stenting remains indicated in cases of visceral or renal malperfusion to restore adequate flow through the collapsed true lumen, even if the false lumen cannot be completely obliterated.
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