Diagnostic and Interventional Radiology
Interventional Radiology - Technical Note

Endovascular occlusion of an aortic coarctation after thoracic endovascular aortic repair of an anastomotic aneurysm

1.

Department of Vascular Surgery, Civil Hospital of Baggiovara, University of Modena and Reggio Emilia, Modena, Italy

Diagn Interv Radiol 2021; 27: 567-569
DOI: 10.5152/dir.2021.20385
Read: 140 Downloads: 29 Published: 07 July 2020

A 58-year-old man with a history of aortic and mitral mechanical valve replacement was referred to our hospital for symptomatic chronic heart failure. In 1988, he had undergone open surgical correction of an isthmic aortic coarctation (CoA), with the creation of an extra-anatomic bypass from the left subclavian artery to the descending thoracic aorta. The following findings were found: severe mitral valve failure with perivalvular leakage, severe aortic valve stenosis, pulmonary hypertension, distal anastomotic aneurysm with the apparent occlusion of the CoA. A thoracic endovascular aneurysm repair was performed. A postoperative high-pressure leak with no evident signs of ineffective sealing was observed. Computed tomography angiography (CTA) 3D reconstruction demonstrated the recanalization of the CoA. A second procedure was planned. The CoA was anterogradely cannulated. Three coils were deployed into the aneurysmal sac, followed by a vascular plug, positioned on the coarctation conduit, but it failed to anchor and dislocated into the sac. A second plug was deployed, but it also partially dislocated. Finally, a patent foramen ovale occluder device was deployed to occlude the communication. The final angiogram showed the complete occlusion of the coarctation and correction of the leak, which was confirmed by a 6-month post-operative CTA.

You may cite this article as: Covic T, Leone N, Gennai S, Silingardi R. Endovascular occlusion of an aortic coarctation after thoracic endovascular aortic repair of an anastomotic aneurysm. Diagn Interv Radiol 2021; 27:567-569

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