A 65-year-old man on ICU has an acute type B aortic dissection with malperfusion syndrome (renal and lower limb ischaemia). Despite optimal medical th...

Question

A 65-year-old man on ICU has an acute type B aortic dissection with malperfusion syndrome (renal and lower limb ischaemia). Despite optimal medical therapy, his left leg remains ischaemic and lactate is rising. What intervention is indicated?

Accepted Answer

Urgent thoracic endovascular aortic repair (TEVAR) to cover the primary entry tear and restore true lumen flow, with consideration of additional endovascular fenestration or stenting for branch vessel malperfusion

Answer

Continue medical therapy and observe

Answer

Open surgical repair of the descending aorta

Answer

Above-knee amputation

Answer

Anticoagulation with heparin only

uk-fficm MCQ (SBA): Complicated Type B Aortic Dissection

A 65-year-old man on ICU has an acute type B aortic dissection with malperfusion syndrome (renal and lower limb ischaemia). Despite optimal medical therapy, his left leg remains ischaemic and lactate is rising. What intervention is indicated?