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John G.T. Augoustides
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Ann Thorac Surg 2006;81:1872-1875
© 2006 The Society of Thoracic Surgeons

Case report

Emergency Endovascular Deployment of Stent Graft in the Ascending Aorta for Contained Rupture of Innominate Artery Pseudoaneurysm in a Pediatric Patient

Wilson Y. Szeto, MD a , Ronald M. Fairman, MD b , Michael A. Acker, MD a , Christopher L. Skelly, MD b , John G.T. Augoustides, MD c , Michael McGarvey, MD d , Edward Y. Woo, MD b , Omaida C. Velazquez, MD b , *

a Division of Cardiothoracic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
b Division of Vascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
c Department of Anesthesia, University of Pennsylvania, Philadelphia, Pennsylvania
d Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania

Accepted for publication July 13, 2005.

* Address correspondence to Dr Velazquez, Department of Surgery, Hospital of Unversity of Pennsylvania, 3400 Spruce St, Fl Silverstein, Philadelphia, PA 19104 (Email: omaida.velazquez{at}uphs.upenn.edu).

Endovascular approaches to treat aortic diseases have become an important alternative to open surgical intervention in aortic pathologies. We report a case of an emergency placement of a stent graft in a 16-year-old boy with a contained rupture of an innominate artery pseudoaneurysm. This patient had been previously treated for a mediastinal T-cell lymphoma and underwent mediastinal chemoradiation. He developed tracheal stenosis, requiring multiple tracheal reconstructive surgical procedures, and subsequently emergency ligation of a tracheal-innominate fistula. A pseudoaneurysm of the previously ligated innominate artery developed. Despite coil embolization, it continued to enlarge, requiring emergency endovascular intervention. A pseudoaneurysm of the previously ligated innominate artery subsequently developed, and despite coil embolization, it continued to enlarge, which required emergency endovascular intervention.






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