title: Treatment of a complicated penetrating ulcer of the descending thoracic aorta using a scalloped stent graft.
abstract: We show the use of a proximal scalloped stent graft for an pseudoaneurysm of the descending thoracic aorta to avoid occlusion of the left subclavian artery. A 63-year-old man with sudden onset dysphonia was diagnosed with left vocal fold paralysis and the presence of a lung mass. A computed tomography scan revealed saccular dilatation of the aortic arch (proximal neck: <10 mm) with suggestive images of a penetrating ulcer and degenerative pseudoaneurysm. A RELAY Plus thoracic stent graft (Bolton Medical, Sunrise, FL) with proximal scallop was implanted to preserve the left subclavian artery. A custom made prosthesis with proximal scallop provides a good alternative to a carotid-subclavian bypass because it is less aggressive and can be used in nonurgent cases.
authors.affiliation: Department of Vascular Surgery, Germans Trias i Pujol Hospital, Badalona, Spain. Electronic address: carlosestebangracia@yahoo.com.
authors.forename: Carlos
authors.initials: C
authors.lastname: Esteban
authors.affiliation: Department of Vascular Surgery, Germans Trias i Pujol Hospital, Badalona, Spain.
authors.forename: Paulina
authors.initials: P
authors.lastname: Pérez
authors.affiliation: Department of Interventional Vascular Radiology, Germans Trias i Pujol Hospital, Badalona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Muchart
authors.affiliation: Department of Interventional Vascular Radiology, Germans Trias i Pujol Hospital, Badalona, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Sampere
authors.affiliation: Department of Vascular Surgery, Germans Trias i Pujol Hospital, Badalona, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Martorell
authors.affiliation: Department of Vascular Surgery, Germans Trias i Pujol Hospital, Badalona, Spain.
authors.forename: Secundino
authors.initials: S
authors.lastname: Llagostera
mesh_terms: D000784:Aortic Dissection / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D055154:Dysphonia / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014456:Ulcer / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D014826:Vocal Cord Paralysis / Q000209:etiology