PMC9478695_01
(a) The ARSA (arrow) is the true origin of the aortic dissection.
(b) The ARSA (arrow) is the entry into the false lumen.. ARSA: aberrant right subclavian artery; T: true lumen; F: false lumen.
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The origin of the ARSA was 17 mm in diameter and emanated from the true cavity (Figure 1(a)). Follow-up computed tomography (CT) was performed 4 years later, revealing that the maximum minor axis of the descending aorta had expanded to 60 mm because of inflow from the ARSA to the false lumen (Figure 1(b)).
(a) Contrast-enhanced image of the ARSA showing inflow of the aortic
dissection into the false lumen. (b) Coil and plug embolization are
performed in the lower part of the ARSA. (c) A thoracic stent graft is
placed.. ARSA: aberrant right subclavian artery.
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Contrast imaging was performed from the ARSA to confirm blood flow into the false lumen (Figure 2(a)). An AMPLATZR Vascular Plug II (16 mm; AGA Medical Corporation, Plymouth, MN, USA) and an Interlock-35 Coil (10 mm x 40 cm; Boston Scientific Co., Marlborough, MA, USA) were placed in the lower part of the ARSA (Figure 2(b)). No endoleak was observed on contrast imaging (Figure 2(c)).
(a) No enlargement of the aneurysm diameter is observed after the TEVAR.
(b) 3D-CT angiography findings.. TEVAR: thoracic endovascular aortic repair; 3D-CT: three-dimensional computed
tomography.
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The maximum minor axis of the aortic dissection was 60 mm and did not change (Figure 3).