Pseudoaneurysms Formation with Hemoptysis after Thoracic Aortic Dissection Stent Implantation in an Athlete: A Case Report

Abstract

Background: Aortic dissection represents a critical surgical emergency characterized by a tear in the aortic intima, allowing blood to enter the media and create a false lumen. It primarily arises due to hypertension and abnormalities in the aortic media. Thoracic endovascular aortic repair (TEVAR) is a standard treatment, though it can lead to complications like pseudoaneurysm formation—a significant concern due to the risk of rupture, requiring vigilant post-operative management.

Case Presentation: We report on a 43-year-old athlete hospitalized for sudden hemoptysis, chest and back pain, and fever lasting four hours. Diagnostic evaluations revealed a thoracic aortic pseudoaneurysm with associated hematoma post-TEVAR, compressing the left lower lung. The patient’s symptoms were alleviated following the implementation of a secondary thoracic aortic stent.

Conclusions: Athletes with acute aortic dissection pose unique challenges due to their high physical activity levels and associated stress on the vascular system. In cases like these, the weakened arterial walls post-stent implantation are particularly prone to pseudoaneurysm formation. Such complications can compress lung tissue, leading to rare but severe symptoms like hemoptysis, and if not promptly managed, can result in extensive lung tissue necrosis or even asphyxia. This case underscores the critical need for immediate re-intervention with aortic angiogram stent implantation upon symptoms of pseudoaneurysm in athletes, reflecting the necessity for tailored surveillance and management strategies in this population to ensure quick return to activity and prevention of severe outcomes.