Transvenous embolization using the Amplatzer Vascular Plug II in patent ductus arteriosus concomitant with Stanford type B aortic dissection: A case report

Abstract

Rationale: Thoracic endovascular aneurysm repair (TEVAR) is commonly used to treat Stanford type B aortic dissections. However, coexistence of aortic dissection and patent ductus arteriosus (PDA) is an extremely rare phenomenon, and TEVAR alone is insufficient for treatment. Herein, a case of endovascular treatment in a patient with both aortic dissection and PDA is reported. Patient concerns: A 31-year-old woman presented to the authors’ hospital with chest pain extending to the back. At presentation, her blood pressure was 130/70 mm Hg. Her father, brother, and uncle were all diagnosed with aortic dissection. Diagnoses: Computed tomography (CT) revealed Stanford type B aortic dissection from the aortic arch to the infrarenal abdominal aorta; however, PDA was incidentally identified. Interventions: TEVAR was immediately performed. Follow-up CT scan performed 2 months later did not reveal any thrombosis or remodeling of the false lumen, and the PDA remained open. Therefore, an additional PDA embolization procedure was performed using the Amplatzer Vascular Plug II via the transvenous route. Outcomes: On follow-up CT performed 6 months after PDA embolization, successful remodeling, and shrinkage of the false lumen were observed, and PDA closure was confirmed. Lessons: If Stanford type B aortic dissection and PDA coexist, TEVAR alone may not be a sufficient treatment and additional PDA embolization may be required. In the present case, transvenous embolization of PDA using an Amplatzer Vascular Plug II was safe and effective.