A reversed strategy for treating type B aortic dissection with open aortoiliac replacement prior to thoracic endovascular aortic repair

Thoracic endovascular stent grafting has been increasingly used in patients with type B aortic dissection (TBAD). We describe a patient with worsening abdominal pain and a rapidly enlarging common iliac artery aneurysm associated with TBAD. The patient underwent open aortoiliac replacement followed by thoracic stent grafting of the TBAD. Computed tomography imaging indicated positive remodeling of the aortic dissection at 3 years. Open abdominal aortic replacement before thoracic endovascular aortic repair may be a useful strategy in patients with TBAD with negative predictors of aneurysmal degeneration.