Hybrid repair of type A aortic dissection after infrarenal endovascular aortic repair and bilateral iliac branched grafts

Type A dissection is infrequently reported after infrarenal endovascular aortic repair (EVAR). Here, we present a case of an EVAR with iliac branch endoprosthesis complicated by type A dissection requiring ascending arch repair. After hemiarch repair, the patient was noted to have residual type B dissection, malperfusion of the left renal artery, and compression of the EVAR with left external iliac limb occlusion. These were treated successfully with iliac thrombectomy and dissection stent placement.