PMC5572050_01
Case 1: Preoperative CT scan showing proximal endoleak (yellow arrow) and contact of the aneurysmal sac with airway. Case 2 : Aneurysm of ascending aorta and proximal endoleak (yellow arrow).
10-1055-s-0037-1606285-i170270crc-1.jpg
PMC5572050_02_10-1055-s-0037-1606285-i170270crc-1.jpg
FI170270crc-1
Patient evolves with sac enlargement and type 1 endoleak ( Fig. 1 : Case 2).
(
A
) Extra anatomical aorto-aortic bypass from ascending aorta (Ao) to supraceliac aorta with dacron graft (pr) through the diaphragm (d). (
B
) Stent removed. (
C
) Thoracic aortic resection and removal of clots.
10-1055-s-0037-1606285-i170270crc-2.jpg
PMC5572050_01_10-1055-s-0037-1606285-i170270crc-2.jpg
FI170270crc-2
The distal end of the descending aorta is closed, and it is excluded from the circulation, and the ascending aorta-supraceliac aorta bypass is constructed (end-to-end) with a Dacron graft # 20 (Hemagard, Maquet, Germany) ( Fig. 2A ).  The aortic arch is opened, and the stent graft is extracted ( Fig. 2B ). Then, the airway is decompressed by removing clots from the descending aorta ( Fig. 2C ) confirmed by bronchoscopy.
PMC5572050_02
Case 1: Preoperative CT scan showing proximal endoleak (yellow arrow) and contact of the aneurysmal sac with airway. Case 2 : Aneurysm of ascending aorta and proximal endoleak (yellow arrow).
10-1055-s-0037-1606285-i170270crc-1.jpg
PMC5572050_02_10-1055-s-0037-1606285-i170270crc-1.jpg
FI170270crc-1
Patient evolves with sac enlargement and type 1 endoleak ( Fig. 1 : Case 2).