Thoracic aortic aneurysm

Case contributed by Dr Nolan Walker

Presentation

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

Patient Data

Age: 60
Gender: Female
Modality: X-ray

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.

CT arterial phase study pre-stenting.

Modality: CT

CT arterial phase study confirms a saccular thoracic aneurysm with a calcified rim. 

Post-stenting study

Modality: CT

CT study axial post stenting of post-traumatic thoracic 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 analysed 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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Case Information

rID: 41586
Case created: 9th Dec 2015
Last edited: 1st Sep 2016
Inclusion in quiz mode: Included

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