Hybrid surgical and endovascular repair for anastomotic pseudoaneurysms after total arch replacement

Abstract

An 83-year-old woman who had undergone total arch replacement for a thoracic aortic aneurysm seven years prior experienced concurrent rupture of second and third branch anastomotic pseudoaneurysms. A stent graft was initially deployed across the pseudoaneurysm from the third branch to the left subclavian artery. Following the left axillary and left carotid arterial bypass, the origin of the second branch was embolized with metallic coils. As a result, both anastomotic pseudoaneurysms were undetectable by both completion angiogram and postoperative CT. By combining surgical and endovascular procedures, ruptured anastomotic pseudoaneurysms after total arch replacement can be repaired without a risky resternotomy.

Keywords:

• Vascular surgical procedures
• endovascular procedures
• blood vessel prosthesis
• aneurysm
• sternotomy
• embolization
• therapeutic

Declaration of interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Additional information

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.