Treatment of a Type II Endoleak from an Atypical Mediastinal Collateral Branch Following Total Arch Replacement with Frozen Elephant Trunk

Annals of Vascular Diseases 2026 Open access

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Authors: Emiko Chiba, Kohei Hamamoto, Mamoru Arakawa, Satoshi Uesugi, Soichiro Kojima, Ryoma Kobayashi, Tatsuya Ogawa, Hiroyuki Fujii, Mitsuru Matsuki, Harushi Mori
DOI: 10.3400/avd.cr.25-00124
Cited by: 0

Abstract

We present a rare case of type II endoleak (T2EL) from an atypical mediastinal artery following total arch replacement with a frozen elephant trunk (FET) for chronic aortic dissection. A 63-year-old male with a history of multiple thoracic aortic surgeries, including FET, developed enlargement of an aortic arch aneurysm on follow-up. Computed tomography and diagnostic angiography revealed a T2EL due to a newly developed mediastinal collateral artery arising from the left subclavian artery feeding the sac. Selective transcatheter embolization with N-butyl-2-cyanoacrylate successfully eliminated the endoleak. Recognizing such atypical T2EL sources is crucial for managing post-FET aneurysm expansion.

Fields of Study & Subjects

Aortic Disease and Treatment Approaches Aortic aneurysm repair treatments Infectious Aortic and Vascular Conditions

Publication details

Journal / source
Annals of Vascular Diseases
Volume
19
Issue
1
Pages
n/a–n/a
Publication date
1 January 2026
Language
EN