title: Percutaneous Repair of Aortic Pseudoaneurysms: A Case Series.
abstract: BACKGROUND
  Aortic pseudoaneurysms (APSAs) are an uncommon but serious complication of aortic surgery with potentially fatal complications if left untreated. Operative repair is associated with significant morbidity and mortality. Percutaneous APSA repair may reduce the risk of these complications and represents an alternative option for patients. We report our experience with percutaneous intervention for the treatment of APSAs.
  
  
  RESULTS
  We retrospectively reviewed all patients at our institution who underwent percutaneous APSA repair with Amplatzer septal occluders and vascular plugs between January 2004 and September 2014. Ten patients are included in this study, representing our first cases of percutaneous APSA repair. Follow-up was performed with serial computed tomographic angiography. The primary outcome was the success rate of device deployment. Secondary outcomes included success rate of complete APSA exclusion, postprocedural symptoms, and periprocedural and postprocedural complications. Mean clinical follow-up time was 12 months (range, 5-30 months) and mean imaging follow-up time was 29 months (range, 14-52 months). Device deployment was successful in all patients, although 2 patients required reintervention due to device malposition and the discovery of additional defects on postprocedure CT angiography. There were no periprocedural or postprocedure complications. Long-term follow-up imaging was available for 7 patients and revealed complete APSA exclusion in 4 patients. One out of the remaining 3 patients ultimately required operative intervention.
  
  
  CONCLUSIONS
  Percutaneous APSA repair can be performed safely with a good procedural success, albeit with variable long-term results. This procedure may be considered as an alternative to surgical repair in select patients.
authors.forename: Zachary L
authors.initials: ZL
authors.lastname: Steinberg
authors.forename: Creighton W
authors.initials: CW
authors.lastname: Don
authors.forename: Jack C J
authors.initials: JC
authors.lastname: Sun
authors.forename: Edward A
authors.initials: EA
authors.lastname: Gill
authors.affiliation: Cardiac Catheterization Laboratory, Department of Cardiology, 1959 NE Pacific Street, Box 356422, Suite AA522, Seattle, WA 98195-6422 USA. stevgolduw@gmail.com.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Goldberg
mesh_terms: D000328:Adult; D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D000072226:Computed Tomography Angiography / Q000379:methods; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D000069451:Long Term Adverse Effects / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D055989:Septal Occluder Device; D013525:Surgical Instruments; D016896:Treatment Outcome; D014481:United States; D062666:Vascular Access Devices