Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2021; 9(34): 10689-10695
Published online Dec 6, 2021. doi: 10.12998/wjcc.v9.i34.10689
Proximal true lumen collapse in a chronic type B aortic dissection patient: A case report
Li Zhang, Wei-Kang Guan, Hua-Ping Wu, Xiang Li, Kai-Ping Lv, Cun-Liang Zeng, Huan-Huan Song, Qian-Ling Ye
Li Zhang, Wei-Kang Guan, Hua-Ping Wu, Xiang Li, Kai-Ping Lv, Cun-Liang Zeng, Huan-Huan Song, Qian-Ling Ye, Department of Vascular Surgery, Dazhou Central Hosptial, Dazhou 0833, Sichuan Province, China
Author contributions: Wu HP, Zhang L, Li X and Lv KP were responsible for the treatment and management of the patient; Song HH and Zeng CL contributed to data collection, literature review, and manuscript writing; Guan WK and Ye QL analyzed the data of the patient; All authors were involved in writing the manuscript and read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the 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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li Zhang, MSc, Associate Chief Physician, Department of Vascular Surgery, Dazhou Central Hosptial, No. 56 Nanyuemiao Street, Tongchuan District, Dazhou 635000, Sichuan Province, China. 50328731@qq.com
Received: April 23, 2021
Peer-review started: April 23, 2021
First decision: June 25, 2021
Revised: July 7, 2021
Accepted: September 14, 2021
Article in press: September 14, 2021
Published online: December 6, 2021
Abstract
BACKGROUND

In the context of aortic dissection, increasing pressure within the newly formed false lumen can result in the progressive compression of the true aortic channel. However, true lumen collapse in chronic type B aortic dissection (cTBAD) patients is rare, with few clinical or experimental studies to date having explored the causes of such collapse.

CASE SUMMARY

In the present report, we describe a rare case of true-lumen collapse in an 83-year-old patient diagnosed with cTBAD, and we discuss potential therapeutic interventions for such cases. Following thoracic endovascular aortic repair (TEVAR), computed tomography angiography revealed satisfactory stent-graft positioning, no endoleakage, true lumen enlargement, thrombus formation in the false lumen, and slight enlargement of the true lumen distal to the stent-graft. Computational hemodynamic analyses indicated that the wall shear stress and pressure within the false lumen were significantly reduced following TEVAR.

CONCLUSION

TEVAR treatment of cTBAD patients suffering from proximal true lumen collapse can facilitate some degree of effective remodeling.

Keywords: True lumen collapse, Chronic type B aortic dissection, Thoracic endovascular repair, Computational hemodynamics analysis, Case report

Core Tip: We describe a rare case of true-lumen collapse in an 83-year-old patient with chronic type B aortic dissection, and we discuss potential therapeutic interventions for such cases.