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Eur J Cardiothorac Surg 2004;25:658-660
© 2004 Elsevier Science NL

Case report

Thoracic aneurysm expansion secondary to collateral supplies via thyrocervical trunk and intercostal arteries in a patient after thromboexclusion

Department of Cardiovascular, Thoracic, and Pediatric Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan

Received 5 October 2003; received in revised form 7 December 2003; accepted 16 December 2003.

^* Corresponding author. Tel.: +81-78-382-5942; fax: +81-78-382-5959
e-mail: yokita{at}med.kobe-u.ac.jp

A case of thoraco-abdominal aortic aneurysm complicated after permanent clamping of the descending aorta (thromboexclusion) is reported. Angiographic and operative findings were: (1) a pseudo-aneurysm right at the distal anastomosis of previous intrathoracic bypass for pseudo-coarctation of the aorta filled by left ninth intercostal artery, which was supplied by the left internal thoracic artery; and (2) the cervical and thoracic spinal cord were supplied by the left vertebral artery and the mediastinal branch of the left thyrocervical trunk. This rare cause of a thoraco-abdominal aortic aneurysm and the significance of the subclavian artery as a source of spinal cord blood supply are discussed.

Key Words: Thoraco-abdominal aortic aneurysm • Akamkiewicz artery • Anterior spinal artery