Saccular “Cauliflower” aneurysm of coarctation of aorta: a hybrid management

Abstract

Aneurysm formation around the site of coarctation of aortic arch is a well-recognised complication of untreated coarctation and is associated with an increased risk of aortic rupture and mortality. We present a rare case in a teenage girl with the combination of significant aortic arch coarctation, a “cauliflower-like” saccular aneurysm, and stenosis at the origin of the left subclavian artery. She was successfully managed with a hybrid approach, which is a combination of an endovascular surgical repair (a bypass graft placement from left carotid artery to subclavian artery by a vascular surgeon) and a transcatheter covered stent placement across the stenosis and aneurysm. This case highlights the successful role of a hybrid approach in patient’s who present with a combination of coarctation of the aorta and aortic arch aneurysms. This approach avoids the conventional surgical aortoplasty, which carries a higher mortality and morbidity risk in teenage patients.

A ruptured descending thoracic aorta pseudo aneurysm in a child presented with chest pain having untreated aortic coarctation: A case report

“…Aneurysms complicating Coarctation may be single or multiple and may occur in the aorta, intercostal arteries, Abbott's artery, or the cerebral vessels [ 8 ]. The anatomic distribution of aneurysms is: 32 % proximal to the Coarctation, 51 % distal, and 17 % involve the left subclavian artery [ 9 ]. Aortic rupture is the major cause of death in untreated Coarctation complicated with aneurysm [ 4 ].…”