Abstract
Aortic arch pseudoaneurysm is a rare condition but carries a high risk of rupture. We report a case of a 45-year-old man with aortic arch pseudoaneurysm between left common carotid artery (LCCA) and left subclavian artery (LSA), in which a endovascular stent graft combined with double chimneys covered stents were successfully placed. There were no any complaints and complications after 12 months follow-up. The CTA demonstrated thrombus formation in the pseudoaneurysm lumen, no endoleak and the aortic arch, LCCA and LSA were all patent. We feel that the combined endovascular and double chimneys may be a valuable therapeutic alternative when treating aortic arch lesion. However, long-term clinical efficacy and safety have yet to be confirmed.
Highlights
Aortic arch pseudoaneurysm is a rare condition but carries a high risk of rupture
Previous reports that we have identified in English literature included conventional surgical repair, hybrid surgery,embolization of an aortic arch pseudoaneurysm with detachable coils and total endovascular debranching of the aortic arch or double-chimney technique [1,2,3,4,5,6,7]
We present a case of aortic arch pseudoaneurysm between left common carotid artery (LCCA) and left subclavian artery (LSA), in which a endovascular stent graft combined with double chimneys covered stents were successfully placed
Summary
Aortic arch pseudoaneurysm is a rare condition but carries a high risk of rupture. Previous reports that we have identified in English literature included conventional surgical repair, hybrid surgery,embolization of an aortic arch pseudoaneurysm with detachable coils and total endovascular debranching of the aortic arch or double-chimney technique [1,2,3,4,5,6,7]. The “C” arm was locked at left anterior oblique (LAO) 45° projection to thoroughly unfold the aortic arch that was cannulated with a 21-French delivery introducer sheath via a 0.035 inch Lunderquist super stiff guidewire (COOK, USA) through the right femoral artery. Two covered stents (8 mm × 60 mm, Fluency, FVL08060, BARD, USA) were cannulated with an 8-French delivery introducer sheath via a 0.035 inch Amplatz super stiff guidewire through the left brachial artery and LCCA and was inserted parallel to the stent graft, respectively. Follow-up CTA 1 week later showed no filling or Figure 2 Postoperative arteriography: disappearance of the aortic arch pseudoaneurysm lumen, no evidence of endoleak and patent of the aorta and the branch of aortic arch immediately after deployment. Postoperative CTA demonstrated thrombus formation in the pseudoaneurysm lumen, no endoleak and the aortic arch, LCCA and LSA were all patent at 12-month follow-up (Figure 3)
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