False aneurysm after balloon dilation of a calcified innominate artery stenosis.
OBJECTIVE
To describe the occurrence of a false aneurysm after percutaneous transluminal angioplasty of a severely calcified, high-grade stenosis of the brachiocephalic trunk.


METHODS
A 68-year-old patient was admitted with cerebrovascular insufficiency, right upper extremity ischemia, and recurrent amaurosis fugax. Magnetic resonance arteriography (MRA) and duplex ultrasound revealed a severely calcified, high-grade stenosis of the innominate artery. Balloon dilation of this lesion was performed with minimal morphological success. After dilation, the patient suffered a reversible ischemic neurological deficit, from which he recovered completely. The patient's symptoms improved, but after 3 weeks he was re-admitted with palsy of the recurrent laryngeal nerve. An MRA showed a false aneurysm at the dilation site. Open surgery was performed, and the patient received a bifurcated aorto-subclavian-carotid bypass graft. He was discharged free of his preoperative symptoms.


CONCLUSIONS
This case illustrates the potential hazards of angioplasty of severely calcified stenoses of the supra-aortic vessels.
Walter
Johannes
J
Department of Vascular Surgery, St John's Hospital, Salzburg, Austria. j.walter@lks.at
Hofmann
Wolfgang J
WJ
Ugurluoglu
Ara
A
Magometschnigg
Heinrich
H
D000368:Aged; D017541:Aneurysm, False / Q000209:etiology*; D001161:Arteriosclerosis / Q000150:complications / Q000628:therapy*; D016122:Brachiocephalic Trunk; D002114:Calcinosis / Q000150:complications / Q000628:therapy*; D002404:Catheterization / Q000009:adverse effects*; D006801:Humans; D008297:Male