Covered stent implantation for anastomotic pseudoaneurysm of innominate artery post total aortic arch replacement

A 59-year-old man presented with back pain that lasted 2 h. Computed tomography revealed acute type A dissection. Emergent total aortic arch replacement was performed on the same day. In 2 weeks later, CT angiography (CTA) showed the aneurysm of his innominate artery. Endovascular repair using covered stent by transbrachial artery approach was successfully performed. CTA at 8 months showed that pseudoaneurysm was excluded. The patient had no symptoms and no other complications were seen. Percutaneous endovascular therapy can be applied for high-risk patient of suprathoracic open surgery.