Custom-made Stent Grafts for the Treatment of Pseudoaneurysms after Childhood Coarctation Surgery

Thorac Cardiovasc Surg. 2019 Jan;67(1):50-54. doi: 10.1055/s-0038-1642629. Epub 2018 May 17.

Abstract

Background: Post-coarctation of the aorta (CoA) pseudoaneurysms is a complication of open repair. Thoracic endovascular repair (TEVAR) is feasible but complicated by proximity to the supra-aortic trunks and severe arch angulation.

Methods: We describe three cases of post-CoA pseudoaneurysms treated with custom-made Relay stent grafts (Vascutek, Scotland).

Results: Technical and clinical success was achieved in all three cases with no mortality, morbidity, endoleaks, or complications. In all three, pseudoaneurysm sac shrinkage was observed at the follow-ups; in one case, there was complete resolution.

Conclusion: Redo open surgery is challenging because of adhesions of the thoracic cavity and associated morbidity and mortality. TEVAR is less invasive and offers fewer complications. Custom-made modifications overcome difficult anatomies including short landing zones and diameter variability.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aneurysm, False / diagnostic imaging
  • Aneurysm, False / etiology
  • Aneurysm, False / surgery*
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / etiology
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortic Coarctation / diagnostic imaging
  • Aortic Coarctation / surgery*
  • Aortography / methods
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Cardiac Surgical Procedures / adverse effects*
  • Endovascular Procedures / instrumentation*
  • Humans
  • Male
  • Prosthesis Design
  • Stents*
  • Tomography, X-Ray Computed
  • Treatment Outcome