Abstract
A 79-year-old woman underwent aortic arch replacement and the maze procedure for ascending and arch aneurysm, and atrial fibrillation, followed two years later by stent graft placement for a descending thoracic aortic aneurysm that had shown a tendency toward enlargement. Computed tomography (CT) after discharge showed type II endoleak thought to arise from the bronchial arteries with an associated increase in aneurysm diameter. Because obstruction caused by compression of the esophagus also became evident, the patient was thought to require treatment at as early a stage as possible. Invasive treatment was judged to be difficult due to the patient’s poor systemic condition, and embolization using direct puncture was selected for treatment. Embolization was performed under local anesthesia with CT-like imaging guidance using cone beam CT. The procedure was completed without complications, and the patient was discharged on postoperative day 18. CT at six months after discharge confirmed the disappearance of endoleak and a reduction in aneurysm size.
