1. Chronic False Aneurysm after a Healed Rupture of the Aortic Isthmus: TEVAR, Hybrid Surgery, or Open Arch Repair?
- Author
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Nizet C, Van Damme H, Boesmans E, Lavigne JP, Creemers E, and Defraigne JO
- Subjects
- Accidents, Traffic, Adult, Aneurysm, False diagnosis, Aneurysm, False etiology, Aortic Aneurysm, Thoracic diagnosis, Aortic Aneurysm, Thoracic etiology, Aortic Rupture diagnosis, Aortic Rupture etiology, Aortography methods, Blood Vessel Prosthesis, Chronic Disease, Humans, Male, Stents, Tomography, X-Ray Computed, Treatment Outcome, Vascular System Injuries diagnosis, Aneurysm, False surgery, Aortic Aneurysm, Thoracic surgery, Aortic Rupture surgery, Blood Vessel Prosthesis Implantation instrumentation, Endovascular Procedures instrumentation, Vascular System Injuries etiology, Vascular System Injuries surgery, Wound Healing
- Abstract
We report a case of post-traumatic chronic false aneurysm of the aortic isthmus in a 34-year-old man who had been involved in a car accident 10 years earlier. An initial chest X-ray demonstrated a calcified mass in the upper mediastinum and computed tomography scan revealed a false aneurysm of the aortic isthmus arising above the left subclavian artery. Partial covered rupture of the aorta is not always easy to diagnose and can remain clinically silent in a polytrauma patient. The duration from rupture to false aneurysm formation may extend over many years. This chronic lesion can be managed by surgery, by an endovascular procedure, or by a combined procedure. This case report highlights the current therapeutic approach. A debranching procedure was done in view of a secondary exclusion of the huge false aneurysm by a stent graft. Unfortunately, the false aneurysm ruptured during the procedure and a replacement of the aortic arch and the isthmus under total circulatory arrest was successfully done. The patient was doing well at 9-month follow-up., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
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