PMC6005811_01
Infrarenal aortic occlusion.
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A 67 year old male patient with hypertension, dyslipidaemia, obesity, chronic obstructive pulmonary disease, sleep apnea syndrome, right ventricular dysfunction secondary to severe pulmonary hypertension, ischaemic stroke and left hemiparesis with complete recovery and without significant carotid stenosis, and normal renal function, presented intermittent claudication of the lower extremities secondary to bilateral aortoiliac occlusion with multiple previous revascularisation procedures: bilateral axillofemoral bypass and thoracic aortofemoral bypass, both occluded (Fig. 1).
Thoracic aorta pseudoaneurysm.
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An anastomotic pseudoaneurysm (APA) of the thoracic aorta measuring 102x87 mm was observed on computed tomography angiography (CTA) (Fig. 2).
Dacron prosthesis extension from a left subclavian artery approach.
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After dissection of the proximal anastomosis of the occluded axillofemoral bypass, a Dacron prosthetic graft (8 mm) was anastomosed to the proximal segment of the bypass (Fig. 3).
Thoracic aortic endograft sealing the pseudoaneurysm.
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Final angiography showed a good seal and there were no endoleaks or complications during the post-operative period (Fig. 4).