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OBJECTIVES: Preventing loss of life in patients with type A acute aortic dissection (AAD) who present with cardiopulmonary arrest (CPA) can be extremely difficult. Thus, we investigated the early outcomes in these patients. METHODS: Patients with type A AAD who were transported to hospitals belonging to the Tokyo Acute Aortic Super-network between January 2015 and December 2019 were considered for this study. We assessed the early mortality of these patients presenting with CPA and also investigated the differences in outcomes between patients with out-of-hospital and in-hospital CPA. RESULTS: A total of 3307 patients with type A AAD were transported, 434 (13.1%) of whom presented with CPA. The overall mortality of patients presenting with CPA was 88.2% (383/434), of which 94.5% (240/254) experienced out-of-hospital CPA and 79.4% (143/180) experienced in-hospital CPA (P < 0.001). Multivariable analysis revealed that aortic surgery [odds ratio (OR), 0.022; 95% confidence interval (CI), 0.008–0.060; P < 0.001] and patient age over 80 years (OR, 2.946; 95% CI, 1.012–8.572; P = 0.047) were related with mortality in patients with type A AAD and CPA. Between in-hospital and out-of-hospital CPA, the proportions of DeBakey type 1 (OR, 2.32; 95% CI, 1.065–5.054; P = 0.034), cerebral malperfusion (OR, 0.188; 95% CI, 0.056–0.629; P = 0.007), aortic surgery (OR, 0.111; 95% CI, 0.045–0.271; P = 0.001), age (OR, 0.969; 95% CI, 0.940–0.998; P = 0.039) and the time from symptom onset to hospital admission (OR, 1.122; 95% CI, 1.025–1.228; P = 0.012) were significantly different. CONCLUSIONS: Patients with type A AAD presenting with CPA exhibited extremely high rates of death. Patient outcomes following in-hospital CPA tended to be better than those following out-of-hospital CPA; however, this difference was not significantly different. To prevent deaths, aortic surgery, when possible, should be considered in patients with type A AAD who sustained CPA. We previously reported a risk analysis for early death in emergency Stanford type A acute aortic dissection (AAD) surgery using the Tokyo Acute Aortic Super (TAAS)-network Registry. [ABSTRACT FROM AUTHOR]

73-year-old male patient was found to have an abdominal aortic aneurysm complicated with bilateral common iliac artery aneurysms. He also had hepatitis C, chronic liver cirrhosis (Child-Pugh class B), a rupture of esophageal varices, hepatocellular carcinoma, and intractable ascites. The functions of other systemic organs were also impaired. We first performed a right internal iliac artery coil embolization prior to stent graft implantation combined with a left external-internal iliac artery bypass. These additional procedures allowed for safe treatment with stent graft implantation, without any serious complications. [ABSTRACT FROM AUTHOR]