Pseudocoarctation following elephant trunk intervention

We describe the case of a 55-year-old man with a pseudocoarctation of the descending aorta following a conventional elephant trunk technique. The patient underwent aortic arch replacement with the conventional elephant trunk technique. After the operation, he had developed an increasing creatinine level, hemolysis, and cyanosis of his toes. Femoral arterial line placement confirmed a 50-mm Hg systolic pressure gradient between his radial and femoral arteries. Computed tomography angiography revealed that the elephant trunk graft within the true lumen was compressed, resulting in a pseudocoarctation. The patient was successfully treated with thoracic endovascular aneurysm repair.