Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2023; 11(18): 4313-4317
Published online Jun 26, 2023. doi: 10.12998/wjcc.v11.i18.4313
Morphological features and endovascular repair for type B multichanneled aortic dissection: A case report
Wei-Feng Lu, Gang Chen, Li-Xin Wang
Wei-Feng Lu, Gang Chen, Li-Xin Wang, Department of Vascular Surgery, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361015, Fujian Province, China
Author contributions: Lu WF and Chen G contributed equally to this work; Lu WF and Wang LX designed the research study; Lu WF, Wang LX and Chen G performed the research; Lu WF, Wang LX and Chen G analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Informed consent statement: The study participant provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Xin Wang, MD, PhD, Doctor, Professor, Surgeon, Department of Vascular Surgery, Zhongshan Hospital (Xiamen), Fudan University, No. 668 Jinhu Road, Huli District, Xiamen 361015, Fujian Province, China. wang.lixin@zs-hospital.sh.cn
Received: February 11, 2023
Peer-review started: February 11, 2023
First decision: March 24, 2023
Revised: April 3, 2023
Accepted: May 16, 2023
Article in press: May 16, 2023
Published online: June 26, 2023
Processing time: 135 Days and 9.2 Hours
Abstract
BACKGROUND

Among the various types of aortic dissection, multichanneled aortic dissection (MCAD) differs from classic double-channeled aortic dissection and involves the formation of an additional false lumen in the aortic wall or the flaps. It is considered a relatively rare condition with high perioperative mortality and morbidity. However, the morphological characteristic and the optimal therapeutic strategy for MCAD has not been fully determined.

CASE SUMMARY

A 64-year-old man presented to our hospital with severe epigastric abdominal pain radiating to the back that was associated with nausea without emesis. A computed tomography angiogram was performed that revealed a type B aortic dissection with multiple channels extending from the level of the left subclavian artery to the bilateral femoral arteries. We used a medical three-dimensional modeling (3D) modeling system to identify the location and extension of multiple lumens from different angles. It also precisely located the two primary entries leading to the false lumens, which helped us to exclude the two false lumens with one stent-graft.

CONCLUSION

By applying medical 3D modeling system, we discover the fragility of aortic wall and the collapse of true lumen caused by the multiple false lumens are the two morphological features of MCAD.

Keywords: Aortic dissection; Endovascular repair; Three-dimensional modeling; Multichanneled; Case report

Core Tip: Multichanneled aortic dissection usually causes the formation of more than two false lumens in the aortic wall. We used medical three-dimensional modeling (3D) modeling system preoperatively to help identify the location and extension of multiple lumens from different angles. It also precisely located the two primary entries leading to the false lumens, which helped us to exclude the two false lumens with one stent-graft. The 3D modeling system has a potential new role in clinical assessment and operative project planning for complicated aortic dissection.