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.
Figure 1. Saccular thoracic aortic aneurysm at site of previous Dacron patch repair for aortic coarctation.
Figure 2. Persistent endovascular leak caused by a breach in PTFE membrane of previously implanted stent.
Figure 3. Residual leak successfully obliterated by 10 large Jackson coils, introduced directly into aneurysm sac through right coronary angiography catheter.
Figure 4. A “nest in the chest.”
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- A Nest in the Chest
