A Rapidly Growing Pseudoaneurysm Secondary to Aortic Arch Periaortitis

We herein report a case of rapidly growing pseudoaneurysm developed shortly after a diagnosis of aortic arch periaortitis. Pseudoaneurysm is a blood leak constrained by compliance of perivascular tissues, in persistent communication with the feeding artery. Chronic periaortitis is characterized by inflammatory involvement of the outer layer of the aorta and surrounding tissues. The major pathogenetic process leading to periaortitis is inflammation, caused by advanced atherosclerosis. Autoimmunity has been proposed as a contributing factor. The present case illustrates an ongoing process of aortic arch periaortitis toward aneurysm formation. Aortic arch pseudoaneurysm is highly susceptible to rupture and sudden death. Our patient achieved a complete remission by a month after receiving an endovascular stent repair and combined treatment with steroid and antibiotics. The disease process was documented by serial CT and radionuclide scanning.