title: Pseudoaneurysm of the aortic arch after aortosubclavian bypass treated with endoluminal stent grafting--a case report.
abstract: This paper describes a case of aortic arch pseudoaneurysm treated with stent graft 2 years after aortosubclavian bypass repair of a subclavian artery aneurysm. An 84-year-old man presented with back pain. Two years before, he had had a left subclavian artery aneurysm repaired with aortosubclavian bypass. Upon examination by computed tomography (CT) scan and angiography he was found to have a bovine arch configuration, a 7-centimeter pseudoaneurysm arising from the stump f the native subclavian artery, a patent aortosubclavian bypass, and a left hemothorax. A 37 mm by 10 mm Gore Excluder thoracic graft was introduced into the right femoral artery cutdown and deployed across the arch, excluding the pseudoaneurysm and preserving the brachiocephalic vessels. Follow up CT scan at 1 year shows exclusion of the pseudoaneurysm. The patient continues to do well 1 year after implantation without evidence of endoleak. In the presence of unusual anatomical characteristics, endoluminal stent graft repair can be successfully performed across the aortic arch.
authors.affiliation: Department of Vascular Surgery, Orlando Regional Medical Center, Orlando, FL, USA.
authors.forename: Charles S
authors.initials: CS
authors.lastname: Thompson
authors.forename: Julio A
authors.initials: JA
authors.lastname: Rodriguez
authors.forename: Venkatesh G
authors.initials: VG
authors.lastname: Ramaiah
authors.forename: Dawn
authors.initials: D
authors.lastname: Olsen
authors.forename: Edward B
authors.initials: EB
authors.lastname: Diethrich
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D017541:Aneurysm, False / Q000000981:diagnostic imaging* / Q000601:surgery*; D000792:Angiography / Q000379:methods; D017130:Angioplasty / Q000295:instrumentation* / Q000379:methods; D001013:Aorta, Thoracic; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018570:Risk Assessment; D015607:Stents; D013348:Subclavian Artery; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods