Thoracic pseudoaneurysm in the ascending aorta is an uncommon condition associated with significant risk of morbidity and mortality. Treatment is recommended in all cases regardless of symptoms as the mortality rate if left untreated has been documented to be as high as 61%. The current standard of care for managing these lesions is open surgical repair. However, this is associated with significant morbidity. In-hospital mortality reported for patients undergoing surgical repair of an ascending aortic pseudoaneurysm ranges from 6.7% to 41%. When anatomically suitable, a less invasive approach using amplatzer vascular plug or septal occluder is an attractive approach. We present a case report of repair of a post-surgical ascending aortic false aneurysm using an amplatzer septal occluder with an Oscor ™ steerable guiding sheath; a novel approach to increase platform stability when engaging an aneurysm neck. Endovascular occluder deployment for closure of aortic false aneurysms remains a relatively novel technique. It is limited by the requirement to develop a stable endovascular platform to deliver the device and avoid system prolapse, particularly when accessing challenging lesions on the inner aortic curvature. We present the first case to utilize a steerable guiding sheath system to improve system stability and facilitate successful device delivery. Given the significant morbidity associated with open repair of these lesions we hope this will further expand the range of lesions viewed as appropriate for endovascular repair.

中文翻译：

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使用 amplatzer 间隔封堵器装置和可操纵导向鞘对术后升主动脉假性动脉瘤进行经皮封堵

升主动脉中的胸廓假性动脉瘤是一种不常见的疾病，与显着的发病率和死亡率风险相关。无论症状如何，都建议在所有情况下进行治疗，因为如果不进行治疗，死亡率高达 61%。目前管理这些病变的护理标准是开放式手术修复。然而，这与显着的发病率有关。接受手术修复升主动脉假性动脉瘤的患者报告的院内死亡率为 6.7% 至 41%。当解剖学上合适时，使用 amplatzer 血管塞或隔膜封堵器的侵入性较小的方法是一种有吸引力的方法。我们提供了一份使用带有 Oscor ™ 可操纵导向鞘的 amplatzer 隔膜封堵器修复手术后升主动脉假动脉瘤的病例报告；一种在接合动脉瘤颈部时增加平台稳定性的新方法。用于关闭主动脉假动脉瘤的血管内封堵器部署仍然是一种相对较新的技术。它受限于需要开发稳定的血管内平台来输送设备并避免系统脱垂，特别是在进入主动脉内曲率的具有挑战性的病变时。我们展示了第一个利用可操纵导向鞘系统来提高系统稳定性并促进成功装置交付的案例。鉴于与这些病变的开放修复相关的显着发病率，我们希望这将进一步扩大被视为适合血管内修复的病变范围。用于关闭主动脉假动脉瘤的血管内封堵器部署仍然是一种相对较新的技术。它受限于需要开发稳定的血管内平台来输送设备并避免系统脱垂，特别是在进入主动脉内曲率的具有挑战性的病变时。我们展示了第一个利用可操纵导向鞘系统来提高系统稳定性并促进成功装置交付的案例。鉴于与这些病变的开放修复相关的显着发病率，我们希望这将进一步扩大被视为适合血管内修复的病变范围。用于关闭主动脉假动脉瘤的血管内封堵器部署仍然是一种相对较新的技术。它受限于需要开发稳定的血管内平台来输送设备并避免系统脱垂，特别是在进入主动脉内曲率的具有挑战性的病变时。我们展示了第一个利用可操纵导向鞘系统来提高系统稳定性并促进成功装置交付的案例。鉴于与这些病变的开放修复相关的显着发病率，我们希望这将进一步扩大被视为适合血管内修复的病变范围。我们展示了第一个利用可操纵导向鞘系统来提高系统稳定性并促进成功装置交付的案例。鉴于与这些病变的开放修复相关的显着发病率，我们希望这将进一步扩大被视为适合血管内修复的病变范围。我们展示了第一个利用可操纵导向鞘系统来提高系统稳定性并促进成功装置交付的案例。鉴于与这些病变的开放修复相关的显着发病率，我们希望这将进一步扩大被视为适合血管内修复的病变范围。