Thoracic aortic aneurysm

Case contributed by Nolan Walker
Diagnosis certain


Incidental finding on post coronary angiogram. Previous RTA 20 years ago. Patient had complained of intermittent inter-scapular back pain.

Patient Data

Age: 60 years
Gender: Female

Frontal chest X-ray reveals an abnormal shape to the aortic knuckle, with peripheral calcification and smooth margins. The lateral projection confirms the calcification to be in the middle mediastinum.



Arterial phase CT confirms a saccular aortic arch aneurysm with a calcified rim. 

Post-stenting study


Control CT post-stenting of the post-traumatic thoracic aortic aneurysm. Aneurysm sac is thrombosed.

Case Discussion

The appearances of aortic root, aortic arch and thoracic artery aneurysms are varied. Abnormalities to the aortic arch knuckle and widening of the mediastinal contours must be analyzed very carefully.

As mentioned in the history, the patient has a medical history of a previous RTA 20 years ago. This was thought to be a post-traumatic aneurysm and was repaired endovascularly.

Patient continues to do well on yearly follow-up.

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