{
  "abstract": "Background: Contemporary management of chronic post-dissection aortic disease includes open repair, thoracic endovascular aortic repair (TEVAR) with or without adjunctive false-lumen occlusion, fenestrated/branched endovascular repair, and staged open-endovascular strategies. Selection depends on anatomy, rupture risk, malperfusion, physiological reserve, and device availability.\n\nCase presentation: A 56-year-old woman with body mass index 47.2 kg/m2 and major cardiometabolic comorbidity presented with progressive abdominal pulsation. CTA demonstrated chronic Stanford type B/DeBakey III dissection with descending thoracic aneurysmal degeneration to 52.7 mm, a dominant symptomatic infrarenal aneurysmal component measuring approximately 11–12 cm, bilateral common iliac involvement, and residual paravisceral dissection without treatment-triggering enlargement or malperfusion. No Crawford extent was assigned because complete longitudinal centerline imaging was unavailable. Stage I comprised transperitoneal open aorto-bi-iliac reconstruction. After 118 days, elective morphology-driven zone 2 TEVAR was performed to cover the reported proximal entry region and reduce antegrade false-lumen inflow. Intentional left subclavian artery (LSA) coverage without prophylactic revascularization was followed by symptomatic subclavian steal requiring unplanned carotid-subclavian bypass.\n\nResults: No perioperative death, stroke, spinal cord ischemia, bowel ischemia, myocardial infarction, acute kidney injury, graft thrombosis, prosthetic infection, or access complication occurred. At latest follow-up, the patient was asymptomatic and all reconstructions were patent.\n\nConclusion: This case illustrates competing priorities in segment-specific management of chronic post-dissection aortic disease. The unequivocal indication for urgent infrarenal repair contrasted with discretionary pre-emptive thoracic intervention below the conventional diameter threshold. The LSA-related complication emphasizes prophylactic LSA preservation/revascularization, spinal collateral planning, and lifelong surveillance of the untreated paravisceral segment after previous abdominal aortic reconstruction.",
  "abstract_shown": true,
  "affiliations": [
    "Center of Interventional Radiology, National Research Oncology Center, Astana, Kazakhstan",
    "Center of Vascular and Reconstructive Surgery, National Research Oncology Center, Astana, Kazakhstan",
    "Doctoral School, Karaganda Medical University, Karaganda, Kazakhstan"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Azat Chinaliyev"
    },
    {
      "affs": [
        1
      ],
      "name": "Mukhammejan Orazbay"
    },
    {
      "affs": [
        2
      ],
      "name": "Gulinur Chinaliyeva"
    },
    {
      "affs": [
        0
      ],
      "name": "Didar Khassenov"
    },
    {
      "affs": [
        1
      ],
      "name": "Tokan Sultanaliyev"
    },
    {
      "affs": [
        1
      ],
      "name": "Irlan Sagandykov"
    },
    {
      "affs": [
        0
      ],
      "name": "Aktolkyn Daumen"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7sex5j4dgcjrd.bib",
  "cited_by": 0,
  "doi": "10.3389/fcvm.2026.1925462",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13696516/",
  "id": "7sex5j4dgcjrd",
  "issns": [
    "2297-055X"
  ],
  "landing_url": "https://doi.org/10.3389/fcvm.2026.1925462",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
    [
      "openalex",
      "2740|Aortic Disease and Treatment Approaches"
    ]
  ],
  "openalex": "W7221536013",
  "pdf_url": "https://europepmc.org/articles/PMC13696516?pdf=render",
  "pmcid": "PMC13696516",
  "pmid": "42935604",
  "published": "2026-10-12",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/7sex5j4dgcjrd.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:51Z",
      "native_id": "PMC13696516",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fcvm.2026.1925462"
    },
    {
      "first_seen": "2026-10-30T12:20:10Z",
      "native_id": "10.3389/fcvm.2026.1925462",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fcvm.2026.1925462/full"
    },
    {
      "first_seen": "2026-10-30T12:22:24Z",
      "native_id": "MED:42935604",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42935604"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2297-055X",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Case Report: staged segment-specific open and endovascular treatment of chronic post-dissection aortic disease with descending thoracic and giant infrarenal aneurysmal components",
  "title_text": "Case Report: staged segment-specific open and endovascular treatment of chronic post-dissection aortic disease with descending thoracic and giant infrarenal aneurysmal components",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:33:50Z",
  "url": "https://research.draconitic.com/paper/7sex5j4dgcjrd",
  "venue": "Frontiers in Cardiovascular Medicine",
  "versions": []
}