Percutaneous closure of pseudoaneurysm of the descending thoracic aorta with septal device occlusion technique

Aortic pseudoaneurysms (APA) typically develop in patients with a history of cardiac or aortic surgery. In addition, any traumatic, inflammatory, or infectious events and spontaneous formation can cause APA (1). The conventional treatment for APA is surgical intervention, which is often associated with high morbidity and mortality, especially in patients with a history of previous cardiac surgery (1, 2). Alternative treatment options include thoracic endovascular aortic repair (TEVAR), coil embolization, thrombin injection, vascular plugs, and off-label use of occluder devices (1-4). We present the case of a patient who had APA in the descending thoracic aorta at the tenth to eleventh vertebral levels, which is also the region of major visceral arteries, such as the celiac trunk and artery of Adamkiewicz (5). Notably, the distal anterior spinal cord vascular territory was at risk of ischemia in case of damage to the artery of Adamkiewicz during endovascular treatments or surgery. To the best of our knowledge, there is limited information regarding the treatment strategies for APA in the descending aorta and other aortic locations. Herein, we discuss a case of APA treated with transcatheter intervention by using an atrial septal defect (ASD) occluder device.