PMC3521286_01
Pseudoaneurysm and its relationship with surrounding structures. (A) Saccular pseudoaneurysm was noted just distal to the orifice of the LSA on the lesser curvature of the aorta on the three-dimensional reconstruction image of the CT. (B) Axial CT scan showed the presence of a post-traumatic aortic pseudo-aneurysm (about 34x26 cm) arising from the DTA at the level of the LSA. LSA, left subclavian artery; CT, computed tomography; DTA, descending thoracic aorta.
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F1
The neck was located immediately after the origin of the left subclavian artery (LSA) on the lesser curvature of the aorta (Fig. 1).
Endograft deployment resulted in near-total coverage of the LSA (A), followed by retrograde chimney stenting of the LSA origin via the trans-brachial approach (B). The landmark for stent graft placement was the origin of the left CCA. Note that the chimney stent was delivered in advance into the LSA, with protruding into the aortic arch lumen. LSA, left subclavian artery; CCA, common carotid artery.
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F2
Next, the chimney stent was deployed in the LSA (Fig. 2).
7 days follow-up CT showing good device morphology and no leakage, patent left CCA, LSA (A), and complete exclusion of the thoracic aortic pseudoaneurysm (B). CT, computed tomography; CCA, common carotid artery; LSA, left subclavian artery.
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F3
A follow-up CT performed after 7 days indicated no proximal endoleak with complete exclusion of the thoracic aortic pseudoaneurysm, as well as free flow into the LSA and left CCA (Fig. 3).