Coil embolization of a false aneurysm with aorto-cutaneous fistula after prosthetic graft replacement of the ascending aorta

Aim: TO report pulliative embolization of a false aneurysm over the distal suture line of an ascending aorta graft replacement. Material and Method: A 78-year-old male patient was admitted for increasing bleeding of a chronic Manubrium ulceration, 20 months after coronary artery bypass complicated b y perioperative ascending aorta dissection requiring prosthetic graft repla cement. One month later, he underwent epiploplasty for a mediastinitis foll owed by long-term antibiotic therapy. Five months later, he presented with a Manubrium ulceration of the sternotomy. Spiral computerized tomography (C T) and aortography revealed a 20 mm anterior peri-prosthetic false aneurysm with a wide neck. Advanced age, active mediastinitis and patient's objecti on led us to perform percutaneous occlusion according to the Moret remodeli ng technique while protecting the coils release with balloon catheter infla tion. Results: No post-operative complication was observed and at I-year fo llow-up the patient was doing well with no recurrent bleeding. Magnetic res onance imaging (MRI) and spiral CT controls confirmed coils stability witho ut any internal flow. Conclusion: Percutaneous coils embolization of a larg e false aneurysm in the ascending aorta can be a palliative treatment in a surgically unsuited patient. (C) 2000 Elsevier Science Ireland Ltd. All rig hts reserved.