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Endovascular treatment of acquired atheromatous aortic arch coarctation  Stephan Kische, MD, PhD, Giuseppe D'Ancona, MD, PhD, Jasmin Ortak, MD, PhD, Yannik.

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Presentation on theme: "Endovascular treatment of acquired atheromatous aortic arch coarctation  Stephan Kische, MD, PhD, Giuseppe D'Ancona, MD, PhD, Jasmin Ortak, MD, PhD, Yannik."— Presentation transcript:

1 Endovascular treatment of acquired atheromatous aortic arch coarctation 
Stephan Kische, MD, PhD, Giuseppe D'Ancona, MD, PhD, Jasmin Ortak, MD, PhD, Yannik Stoeckicht, MD, Hüseyin Ince, MD, PhD  Journal of Vascular Surgery Cases  Volume 1, Issue 1, Pages 3-5 (March 2015) DOI: /j.jvsc Copyright © 2015 The Authors Terms and Conditions

2 Fig 1 A, Three-dimensional magnetic resonance image shows severe stenosis of the arch (black arrow) distal to the left common carotid artery (LCCA) with a concomitant aneurysm in close vicinity to the aortic obstruction. B, Three-dimensional reconstruction from an electrocardiogram-gated computed tomography (CT) confirms extensive calcification within the middle-distal arch. C, The accompanying aneurysm presents with an irregular shape. Virtual angioscopy depicts the target lesion as viewed from the ascending aorta, thus demonstrating a calcified subocclusive plug proximal to the origin of the left subclavian artery (LSA). The white arrows indicate the unaffected ostia of the brachiocephalic trunk (TBC) and the LCCA. The spatial relations between the intraluminal calcification, the poststenotic aneurysm (black arrows), and the supraaortic branches are further clarified by (D) a virtually sketched view and by (E) the axial slices. Journal of Vascular Surgery Cases 2015 1, 3-5DOI: ( /j.jvsc ) Copyright © 2015 The Authors Terms and Conditions

3 Fig 2 Follow-up computed tomography (CT) scan shows the thoracic aorta anatomy 12 months after endovascular repair of the acquired aortic coarctation. A, A three-dimensional reconstruction shows the endoprosthesis within the distal aortic arch. To avoid unprotected side branch coverage, a left subclavian artery (LSA) transposition was performed before the endoprosthesis placement (black arrow). B, Discrete residual compression of the proximal stent by compact calcified debris (white arrows) is displayed in a cross-sectional plane and (C) further clarified by a virtual angioscopy. D, Note that the obstructed lumen has been adequately reconstructed with exclusion of the convoluted poststenotic aneurysm (*). Journal of Vascular Surgery Cases 2015 1, 3-5DOI: ( /j.jvsc ) Copyright © 2015 The Authors Terms and Conditions

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