{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T02:56:14Z","timestamp":1782874574165,"version":"3.54.5"},"reference-count":12,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. vasc. bras."],"abstract":"<jats:p>Abstract The presence of malperfusion syndrome in cases of complicated acute type B aortic dissection is a negative predictive factor and urgent intervention is indicated. Anatomic variations, such as the Arc of Buhler, contribute anastomotic channels and can preserve the visceral blood supply. In this case report, we describe the overall management of a 54-year-old man who presented with a type B aortic dissection. Initially, conservative management was chosen, as indicated for an uncomplicated type B dissection, but the dissection deteriorated. Despite the fact that severe occlusion of the celiac artery was detected on Computed Tomography (CT) angiography, the Arc of Buhler anatomical variation was present, contributing adequate visceral blood supply. After considering this finding, the patient was treated effectively with thoracic endovascular aortic repair (TEVAR).<\/jats:p>","DOI":"10.1590\/1677-5449.200045","type":"journal-article","created":{"date-parts":[[2020,11,24]],"date-time":"2020-11-24T03:48:12Z","timestamp":1606189692000},"source":"Crossref","is-referenced-by-count":4,"title":["Arc of Buhler: A lifesaving anatomic variation. A case report"],"prefix":"10.1590","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3523-4881","authenticated-orcid":false,"given":"Schizas","family":"Nikolaos","sequence":"first","affiliation":[{"name":"Evangelismos General Hospital of Athens,  Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patris","family":"Vasilios","sequence":"additional","affiliation":[{"name":"Evangelismos General Hospital of Athens,  Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lama","family":"Niki","sequence":"additional","affiliation":[{"name":"Kapodistrian University of Athens,  Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleftherios Orestis","family":"Argyriou","sequence":"additional","affiliation":[{"name":"Whipps Cross University Hospital,  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kratimenos","family":"Theodoros","sequence":"additional","affiliation":[{"name":"Evangelismos General Hospital of Athens,  Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Argiriou","family":"Mihalis","sequence":"additional","affiliation":[{"name":"Evangelismos General Hospital of Athens,  Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2020]]},"reference":[{"issue":"6","key":"ref1","doi-asserted-by":"crossref","first-page":"S98","DOI":"10.1016\/j.jtcvs.2010.07.036","article-title":"Treatment for malperfusion syndrome in acute type A and B aortic dissection: A long-term analysis","volume":"140","author":"Deeb GM","year":"2010","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"7","key":"ref2","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1001\/jama.283.7.897","article-title":"The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease","volume":"283","author":"Hagan 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management of arc of buhler aneurysm","volume":"24","author":"Dubel G","year":"2007","journal-title":"Interventional Management of Arc of Buhler Aneurysm Semin Intervent Radiol."},{"issue":"1","key":"ref10","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.jtcvs.2011.10.093","article-title":"Midterm results after endovascular treatment of acute, complicated type B aortic dissection: the Talent Thoracic Registry","volume":"145","author":"Ehrlich MP","year":"2013","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"2","key":"ref11","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.jvs.2019.04.478","article-title":"Thoracic endovascular aortic repair with stent grafts alone or with a composite device design in patients with acute type B aortic dissection in the setting of malperfusion","volume":"71","author":"Sobocinski J","year":"2020","journal-title":"J Vasc 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