Recurrent Aortic Dissection Presenting with Repeated Transient Ischemic Attacks: A Novel Pathophysiology and Successful Endovascular Treatment

Aortic dissection is the most common and the most lethal event that can involve the aorta. Typically, aortic dissection presents with sharp, tearing, or ripping pain. Alternatively, the patients may suffer from possible extension of the dissecting aneurysm into the supra-aortic vessels resulting in syncope in 9.4 % of patients cerebrovascular accidents in 4.7 %. We present a case of recurrent aortic dissection, which presented with recurrent transient ischemic attacks (TIAs). The etiology of the neurological symptoms was attributed to a steal phenomenon. The right subclavian artery was supplied by retrograde flow from the right internal carotid artery through the false lumen of the dissection. To prevent further hemodynamic TIAs, we successfully occluded the proximal part of the false lumen of the dissection responsible for the steal phenomenon.