Endovascular Repair of Ascending Aortic Pseudoaneurysm Using Transfemoral Frame-Coiling Under Total Cerebral Protection

Ascending aortic pseudoaneurysms are associated with prior cardiac surgery and have a high chance of rupture. Open surgery is challenging given its likely reoperative nature. Various endovascular therapies have been described but are sometimes complicated by stroke. We present a patient with a prior coronary artery bypass grafting who was referred for an incidental 3-cm saccular ascending aortic pseudoaneurysm who was successfully treated with frame coiling under total cerebral embolic protection using the SENTINEL device. We propose that endovascular obliteration of ascending aortic pseudoaneurysms is a viable option in patients unfit for open repair and advocate for total cerebral embolic protection as an important adjunct.