Embolization of pseudoaneurysm in Dacron subclavian-aortic graft for interrupted aortic arch repair. Case resolution

CASE RESOLUTION The patient was referred to the cath lab. The high left brachial artery access was tried using the dissection technique due to significant stenosis of the distal brachial artery as a consequence of an aortography performed during the patient’s childhood with the Sones technique. General anesthesia with selective orotracheal intubation was used. A 6-Fr Cobra-type guide catheter was advanced and entered the pseudoaneurysm. An early injection was used for its catheterization (video 1 and video 2 of the supplementary data) (neck: 8.4 mm; base: 2.9 x 1.5 cm). Three fiber coils (6 mm with 5 turns) were deployed in the base of the pouch (figure 1). Afterwards, a 5 x 4 mm Amplatzer ADO II device was positioned and delivered in the pseudoaneurysm neck. The persistence of the passage of contrast to the pouch was evident and it was decided to deliver another 6.5 mm fiber coil with 3 turns to finish the pseudoaneurysm neck sealing (figure 2, video 3 of the supplementary data). One month after the procedure, the patient had a new episode of hemoptysis. The coronary computed tomography angiography performed confirmed the patency of the pouch in its proximal portion, which is why the..