Use of a percutaneous septal occlusion device to exclude a juxta-renal pseudoaneurysm of the abdominal aorta

Endovascular Repair for Thoracic Aortic False Aneurysms: Single-Center Experience in 102 Patients

BACKGROUND

Thoracic aortic false aneurysm is unusual and experience with endovascular repair is limited. We evaluate the efficacy of endovascular repair in patients with thoracic aortic false aneurysms.

METHODS

The early and midterm outcomes of endovascular repair in 102 patients with thoracic aortic false aneurysms were analyzed.

RESULTS

There were 80 men and 22 women (age 54.9 ± 13.7 years). Emergent or urgent endovascular repair was done in 19 cases (18.6%) and elective in 83 (81.4%). Procedure was successful in 99.0%. Early death occurred in 4 patients (3.9%). No early death occurred in elective patients. Early complications occurred in 7 patients (6.9%). Follow-up was complete in 100% for 24.0 ± 18.5 months (range, 1.5 to 67.3). Fourteen late deaths occurred (13.7%). Late events occurred in 9 patients (8.8%). Survival at 6 month, 1 year and 3 years was 90.7%, 86.7% and 84.5%, respectively.

CONCLUSIONS

Satisfactory early and midterm outcomes have been achieved with endovascular repair in this series. Although emergent or urgent patients had higher rates of early mortality and morbidity, the majority of them achieved stable late survival as long as they survived at least 6 months. These results argue favorably for use of endovascular repair in the management of patients with thoracic aortic false aneurysms.

Management of giant posttraumatic abdominal aortic pseudoaneurysm and aortic occlusion using a unique hybrid procedure combining transcatheter device closure and open surgical repair

Posttraumatic abdominal aortic pseudoaneurysm (AAP) is a rare but life-threating disease. Here, we described a case of posttraumatic AAP with acute abdominal aortic occlusion and its successful treatment using a unique hybrid procedure. An 18-year-old male was referred, with a giant AAP among visceral arteries, which occluded the aorta and left renal artery. An infrequently used ventricular septal device was delivered via femoral access and successfully plugged the tear. Then the isolated pseudoaneurysm was resected through open surgery without major bleeding. At 6 months after operation, the patient was alive without evidence of complications. This hybrid procedure combining transcatheter device closure and open surgery was a successful attempt in the subemergency treatment of posttraumatic AAP.