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Case 8
Acute Type B dissection with leg ischaemia
A 45 year old previously exceptionally fit Afro Caribbean gentleman presents with a cold pulseless right leg. This occurred after a period of tearing lower back pain. His PMHx is of note for uncontrolled hypertension.
This chap had a CT scan that showed the dissection was limited to his lower descending and abdominal aorta.
What would you do ?
He needs blood flow restored to his leg!
Options include:
This chap had two stents inserted into his descending thoracic aorta. Unfortunately this did not restore flow, so a femoral femoral cross over graft was performed.
Follow up should be lifelong for BP management, (remember Afro Caribbean people do not respond to B blockers), and regular CT or MRI scanning to evaluate his aorta for aneurysmal dilatation.
CT scan
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