PT  - JOURNAL ARTICLE
AU  - Mehra, Rohit
AU  - Swain, Pranati
AU  - Aggarwal, Rohit
AU  - Balasubramaniam, Dhanalakshmi
TI  - Complex aortic-arch pseudoaneurysm with aorto-innominate vein fistula in a case of traumatic chest injury
AID  - 10.1136/bcr-2024-260184
DP  - 2024 Mar 01
TA  - BMJ Case Reports
PG  - e260184
VI  - 17
IP  - 3
4099  - http://casereports.bmj.com/content/17/3/e260184.short
4100  - http://casereports.bmj.com/content/17/3/e260184.full
SO  - BMJ Case Reports2024 Mar 01; 17
AB  - A patient in his late 30s presented with issues of retrosternal chest pain and palpitations. He had sustained a splinter injury to the left hemithorax a year ago for which he had been managed with a tube thoracostomy. During subsequent evaluations, he was found to have atrial fibrillations and a CT angiography revealed an arch of the aorta pseudoaneurysm with a fistulous communication with the innominate vein, which being a rare condition has no established treatment protocols. Endovascular salvage of the condition required an aortic Ishimaru zone 2 deployment of the thoracic endovascular aortic repair stent graft to provide an adequate landing zone. The elective left subclavian artery revascularisation was obtained by a left carotid artery to left subclavian artery bypass. Post procedure there was complete exclusion of the pseudoaneurysm sac, and the fistulous aorto-venous communication inflow tract. The patient recuperated well and has returned to full active duties.