A rare case of an acute type B aortic dissection contained infrarenal rupture of the false lumen after prior endovascular abdominal aneurysm repair

New-onset acute type B aortic dissection (ATBD) after prior endovascular aneurysm repair (EVAR) is extremely rare. The extension of aortic dissection can cause destabilization of the previously implanted stent graft, thrombosis of the stent graft, and the rupture of the aneurysmal sac with high mortality rate without therapy. This report describes the case of a 66-year-old patient complaining of sudden abdominal pain radiating to both flanks. A computed tomography angiography (CTA) of the aorta revealed ATBD with infrarenal rupture of the false lumen after endovascular abdominal aneurysm repair five years prior. The patient underwent infrarenal open surgical conversion with suprarenal aortic clamping and implantation of a bifurcated dacron graft. Postoperatively no serious complications occurred of the treatment, except a fascial dehiscence. In these cases, the patients can be treated in an emergency situation with open repair in spite of the high risk for complications and mortality