Chronic False Aneurysm after a Healed Rupture of the Aortic Isthmus: TEVAR, Hybrid Surgery, or Open Arch Repair?
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- 作者：Christophe Nizet ; cnizet@student.ulg.ac.be" class="auth_mail" title="E-mail the corresponding author ; Hendrik Van Damme ; Evelyne Boesmans ; Jean-Paul Lavigne ; Etienne Creemers ; Jean-Olivier Defraigne
- 刊名：Annals of Vascular Surgery
- 出版年：2016
- 出版时间：February 2016
- 年：2016
- 卷：31
- 期：Complete
- 页码：205.e11-205.e16
- 全文大小：593 K
文摘
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.