Emergency Endovascular Management of a Symptomatic Pseudoaneurysm of the Left Subclavian Artery Ostium Using a Combination of an Abdominal Aortic Stent-Graft Extension Cuff and a Periscope Stent Graft

Ann Vasc Surg. 2019 Feb:55:307.e13-307.e17. doi: 10.1016/j.avsg.2018.06.033. Epub 2018 Sep 12.

Abstract

A pseudoaneurysm located at the subclavian artery ostium is an infrequent but life-threatening pathology that usually requires major thoracic surgery with a high risk of mortality and morbidity. Endovascular therapy applied to the aortic arch branches is a recent alternative technique, which is still in its early stages because dedicated endovascular devices for the aortic arch are lacking. In this article, we present the emergency endovascular management of a symptomatic pseudoaneurysm of the left subclavian artery ostium which was presumably secondary to an atherosclerotic plaque rupture. Endovascular exclusion required a combination of an abdominal aortic stent-graft extension cuff, which was placed via a retroperitoneal iliac access, and a subclavian artery periscope stent graft.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Aneurysm, False / diagnostic imaging
  • Aneurysm, False / etiology
  • Aneurysm, False / surgery*
  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / surgery*
  • Aortic Diseases / complications
  • Aortic Diseases / diagnostic imaging
  • Aortic Diseases / surgery*
  • Aortography / methods
  • Atherosclerosis / complications
  • Atherosclerosis / diagnostic imaging
  • Atherosclerosis / surgery*
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Computed Tomography Angiography
  • Emergencies
  • Endovascular Procedures / instrumentation*
  • Humans
  • Male
  • Prosthesis Design
  • Stents*
  • Subclavian Artery / diagnostic imaging
  • Subclavian Artery / surgery*
  • Treatment Outcome