Endovascular repair of aortic coarctation pseudoaneurysm using an off-label "hourglass" stent-graft configuration

Young Erben, Gustavo S. Oderich, Audra A. Duncan

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Purpose: To describe an endovascular technique for treating a pseudoaneurysm of the thoracic aorta using an off-label "hourglass" stent-graft configuration. Case Report: A 68-year-old patient with prior open thoracic aorta coarctation repair presented with recurrent coarctation and concurrent enlarging 6-cm bilobed pseudoaneurysm involving the previous anastomosis. There was significant discrepancy in the aortic diameter (measured from wall to wall) proximal to the coarctation (14 mm), at the narrowest segment (8 mm), and distally (23 mm). Endovascular repair included deployment of an inverted iliac limb proximally, followed by an inverted aortic converter distally, giving an "hourglass" configuration. There were no perioperative or stent-graft-related complications at 5-year follow-up. The aneurysm regressed from 61 to 25 mm. Conclusion: The use of inverted stent-grafts can allow tapering and flaring to adapt to discrepant aortic diameters. This technique may be useful in select patients with prior coarctation repair who do not need excessive dilation of the narrow aortic segment.

Original languageEnglish (US)
Pages (from-to)460-465
Number of pages6
JournalJournal of Endovascular Therapy
Issue number3
StatePublished - Jun 1 2015


  • Coarctation
  • Endovascular repair
  • Iliac limb stent-graft
  • Physician-modified device
  • Pseudoaneurysm
  • Recurrent coarctation
  • Reversed stentgraft
  • Stent-graft

ASJC Scopus subject areas

  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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