Proximal aortic perforation after endovascular repair of a type B dissection in a patient with Marfan syndrome

Several successful cases of endovascular treatment of type B dissections in patients with Marfan syndrome have been reported. In our patient with Marfan syndrome, a type B dissection was successfully treated endovascularly. Three weeks after this procedure, a computed tomographic angiography (CTA) revealed a perforation of the aortic wall distal to the left subclavian artery by a bare strut of the stent graft. A second stent graft was placed to treat this complication. In patients with Marfan syndrome, complications might be prevented by using stent grafts specifically developed to treat dissections. However, specific complications, eg, perforation, must be taken into account and patients have to be followed attentively.