Acute type B aortic dissection after ruptured thoracoabdominal aortic aneurysm repair resulting in thoracoabdominal branch endoprosthesis collapse and malperfusion

We report the case of a patient who developed an acute Stanford type B aortic dissection 4 days after thoracoabdominal branch endoprosthesis repair for a ruptured thoracoabdominal aortic aneurysm. The dissection caused complete endograft collapse and profound malperfusion. Emergent salvage endovascular repair successfully re-expanded the graft; however, the patient ultimately died because of the severity of the systemic injuries. This case highlights the potential for acute type B aortic dissection to occur in a recently stented thoracic aorta segment following thoracoabdominal branch endoprosthesis repair and emphasizes the need for urgent recognition of malperfusion and meticulous computed tomography evaluation of the aortic injury pattern.