A Nest in the Chest
A 35-year-old woman presented with a saccular thoracic aortic aneurysm at the site of a previous Dacron patch repair for aortic coarctation (Figure 1). The aneurysm was initially treated with 2 covered stents (NuMed CP), 50 and 39 mm long. Follow-up angiography revealed a persistent endovascular leak at the distal end of the previously stented area, and an additional 50-mm covered stent was implanted. Follow-up angiography revealed a persistent endovascular leak (Figure 2) caused by a breach in the PTFE membrane of a previously implanted stent. Rather than implant another covered stent, the residual leak was successfully obliterated by 10 large Jackson coils, introduced directly into the aneurysm sac through a right coronary angiography catheter (Figure 3). The patient’s chest x-ray is shown in Figure 4. The appearance on angiography and chest x-ray is that of a nest in her chest. She remained well on clinical follow-up at 6 months after the procedure.