Related Experiment Video
Updated: Jan 10, 2026
Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
Published on: August 1, 2025
Successful Application of TEVAR With a Vascular Plug for Treatment of Pseudoaneurysm in Ascending Aorta
Sedem Dankwa1, Irbaz Hameed1, Meghna Khandelwal1
1Division of Cardiac Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.
Background:
Pseudoaneurysms are a rare but serious complication after aortic surgery, carrying a significant risk of mortality if left untreated.
Case Summary:
A 65-year-old man with type 4 Loeys-Dietz syndrome and a history of multiple aortic aneurysm repairs presented to clinic with chest pain and shortness of breath. Computed tomography angiography revealed an enlarging 15-mm pseudoaneurysm in the mid ascending aorta. Given his complex surgical history, including aortic root and arch replacement, reinterventions, and MitraClip implantation, he was deemed at high risk for open surgery. Thoracic endovascular aortic repair (TEVAR) with the Amplatzer Vascular Plug II (AVP II) was performed, successfully occluding the pseudoaneurysm. One-year follow-up computed tomography angiography showed complete thrombosis with no endoleak.
Discussion:
This case is distinguished by the durability of AVP II closure of a mid ascending aortic pseudoaneurysm in a patient with extensive prior aortic surgeries and a genetic aortopathy, in which endovascular repair is typically contraindicated owing to aortic wall fragility.
Take-Home Message:
Endovascular repair using TEVAR with AVP II can be a viable salvage strategy for ascending aortic pseudoaneurysms in patients at prohibitive surgical risk, including those with genetically triggered aortopathies.
