Abstract/Description

Background: Pseudoaneurysm formation following cardiac procedures can be a significant complication due to the high risk of rupture. Traditionally managed through sternotomy and cardiac surgery, innovative percutaneous interventions have shown promise for high-risk patients. This case report highlights the successful application of ICE-guided percutaneous coil embolization for the treatment of aortic pseudoaneurysms, presenting a less invasive alternative for patients for whom traditional surgery poses significant risks.

Case Summary: A patient with a complex cardiovascular history, including aortic root and ascending aorta replacement and CABG x2, developed two pseudoaneurysms below the right coronary button and at the distal aortic graft-native aorta anastomosis. These were initially deemed unsuitable for endovascular repair due to size and position. Over time, with no suitable surgical options and increased risk of open redo surgery, a decision was made for ICE-guided percutaneous coil embolization. The procedure was executed successfully without any postoperative complications, demonstrating a significant decrease in the pseudoaneurysm size and associated fluid collection, establishing an effective non-surgical treatment modality.

Discussion: The use of ICE-guided percutaneous coil embolization in this case illustrates a novel approach to managing ascending thoracic aortic pseudoaneurysms, especially in anatomically challenging locations and in patients with significant surgical risks.

Presenting Author Name/s

Moudar Jano

Faculty Advisor/Mentor

Matthew Summers, MD

Faculty Advisor/Mentor Department

Sentara Heart Hospital

College/School/Affiliation

Sentara

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ICE Guided Percutaneous Pseudoaneurysm Coil Embolization

Background: Pseudoaneurysm formation following cardiac procedures can be a significant complication due to the high risk of rupture. Traditionally managed through sternotomy and cardiac surgery, innovative percutaneous interventions have shown promise for high-risk patients. This case report highlights the successful application of ICE-guided percutaneous coil embolization for the treatment of aortic pseudoaneurysms, presenting a less invasive alternative for patients for whom traditional surgery poses significant risks.

Case Summary: A patient with a complex cardiovascular history, including aortic root and ascending aorta replacement and CABG x2, developed two pseudoaneurysms below the right coronary button and at the distal aortic graft-native aorta anastomosis. These were initially deemed unsuitable for endovascular repair due to size and position. Over time, with no suitable surgical options and increased risk of open redo surgery, a decision was made for ICE-guided percutaneous coil embolization. The procedure was executed successfully without any postoperative complications, demonstrating a significant decrease in the pseudoaneurysm size and associated fluid collection, establishing an effective non-surgical treatment modality.

Discussion: The use of ICE-guided percutaneous coil embolization in this case illustrates a novel approach to managing ascending thoracic aortic pseudoaneurysms, especially in anatomically challenging locations and in patients with significant surgical risks.