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Vascular and Endovascular Surgery
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Pseudoaneurysm of the Aortic Arch After Aortosubclavian Bypass Treated with Endoluminal Stent Grafting

A Case Report

Charles S. Thompson, MD

Department of Vascular Surgery, Orlando Regional Medical Center, Orlando, FL

Julio A. Rodriguez, MD

Department of Cardiovascular and Endovascular Surgery, Arizona Heart Institute and Arizona Heart Hospital, 2632 North 20th Street, Phoenix, AZ 85012

Venkatesh G. Ramaiah, MD

Dawn Olsen, PA-C

Edward B. Diethrich, MD

Department of Cardiovascular and Endovascular Surgery, Arizona Heart Institute and Arizona Heart Hospital, Phoenix, AZ

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 of 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.

Vascular and Endovascular Surgery, Vol. 37, No. 5, 375-379 (2003)
DOI: 10.1177/153857440303700511
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