Endovascular repair of an aortic arch pseudoaneurysm by an atrial septal defect occluder combined with a chimney stent

An aortic arch pseudoaneurysm distal to the left common carotid artery (LCCA) was repaired endovascularly with an atrial septal defect occluder. Aortography showed complete closure of the pseudoaneurysm but delayed blood flow in the LCCA. A chimney stent was then placed into the LCCA to salvage it. Completion angiography suggested free flow in the LCCA and a minor perioccluder leak, which disappeared at 1-month follow-up. The patient was free from any symptoms related to the pseudoaneurysm at 1-year follow-up, with the atrial septal defect occluder in a satisfactory position, absence of leaking, and complete thrombosis in the pseudoaneurysm cavity.