Spontaneous Thoracic Aortic Pseudoaneurysm Treated with Endovascular Grafting in a Hemodialysis Patient

Abstract

limited with specific anatomical considerations and complications. Particularly in high risk patients, endovascular approach offers lower morbidity and mortality(2,3). A 51 year-old male patient with renal failure experienced dyspnea during dialysis. Chest radiogram revealed massive left-sided pleural effusion. Thoracic computerized tomography documented pseudoaneurysm in thoracic aorta distal to left subclavian artery (48.5x29.1 mm) (Figures 1, 2). There was no history of trauma or percutaneous/ surgical intervention; possibly the atherosclerotic plaque weakened the wall and lead to aortic rupture during a hypertensive attack and pseudoaneurysm developed. Successful endovascular treatment was performed (Figure 3). Left hemithorax was tube-drained after the procedure (defibrinated blood), because preceding intervention could decompress the pseudoaneurysm sac and lead to rupture. The postoperative course was uneventful

Keywords

• Aorta, thoracic; aneurysm, false; renal insufficiency; endovascular procedures

Bir Hemodiyaliz Hastasında Endovasküler Greftleme ile Tedavi Edilen Spontan Torasik Aort Yalancı Anevrizması

Abstract

Keywords

• Aort, torasik; anevrizma, yalancı; böbrek yetmezliği; endovasküler prosedürler

References

1. Yilmaz O, Arbatli H, Sirin G, Arpaz M, Yagan NE, Numan F, et al. Endovascular treatment of traumatic thoracic aortic aneurysms: Report of five cases and review of the literature. Ulus Travma Acil Cerrahi Derg 2010;16:575-8.
2. Demetriades D, Velmahos GC, Scalea TM, Jurkovich GJ, Karmy-Jones R, Teixeira PG, et al; American Association for the Surgery of Trauma Thoracic Aortic Injury Study Group. Operative repair or endovascular stent graft in blunt traumatic thoracic aortic injuries: results of an American Association for the Surgery of Trauma Multicenter Study. J Trauma 2008;64:561-70.
3. Yaşa H, Bayrak S, Ali Gürbüz A. Abdominal Aort Anevrizmalarında Hibrid Girişimler. Turkiye Klinikleri J Cardiovasc Surg-Special Topics 2011;3:52-60.
4. Figure 2. Three dimensional reconstruction
5. of thoracic aorta clearly demonstrated the
6. pseudoaneurysm formation (arrow).
7. Figure 3. Intraoperative angiography showed
8. successful exclusion of the pseudoaneurysm sac by

9. endovascular stent grafting.