PMC6319520_01
A 76-year-old male with massive hemoptysis. a and b. CT showed two aortic pseudoaneurysms (arrows), which were in contact with the aortic anastomoses. They were attached to the trachea and left bronchus, respectively, which was suggestive of AB fistula formation. c and d. Two months before a and b, CT showed that an aortic pseudoaneurysm had blood flow (arrow). After that, the psuedoaneurysn increased in size
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Fig1
They were attached to the trachea and the left bronchus, which was suggestive of AB fistula formation (Fig. 1).
a and b. Two stent-grafts were inserted into the region extending from the aortic arch (elephant trunk) to the descending aorta. CT showed a type 2 endoleak. The pseudoaneurysms remained (arrows). c and d. CT showed a type 2 endoleak via the bronchial artery (arrows). e. Brachiocephalic arteriography showed a type 2 endoleak (arrow) into the aortic pseudoaneurysms from the supreme intercostal artery via the bronchial artery. f. After TAE, the type 2 endoleak disappeared
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Fig2
The pseudoaneurysms remained (Figs. 2a and b). Next, the right brachial artery was punctured, and brachiocephalic arteriography was carried out, which showed a type 2 endoleak into the aortic pseudoaneurysms from the supreme intercostal artery via the bronchial artery (Fig. 2c). TAE, the type 2 endoleak disappeared (Fig. 2d).
a and b. One year later, CT showed that the anastomotic pseudoaneurysms had disappeared, and the diameter of the aorta had also reduced
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Fig3
One year later, CT showed that the pseudoaneurysms had disappeared, and the diameter of the aorta had also reduced (Fig. 3).