{
  "abstract": "Background: Ascending aortic penetrating atherosclerotic ulcers (PAUs) are rare acute aortic syndromes, where guidelines recommend surgical repair. In surgically ineligible patients, endovascular repair has been described; however, data on management of postoperative complications are limited.\n\nCase Summary: A frail 75-year-old woman presented with dyspnea, 1 month after emergency endovascular repair of a ruptured ascending aortic PAU. Computed tomography aortography (CTA) demonstrated a late type IA endoleak with associated pseudoaneurysm. Given her prohibitive surgical risk, a staged approach was initially used by creating a scaffold with transcatheter aortic valve implantation and deployment of an atrial septal defect occluder across the pseudoaneurysm's neck, followed by patent foramen ovale occluder implantation, coil packing, and thrombin injection. This achieved complete endoleak exclusion and pseudoaneurysm sealing, confirmed on serial CTAs. The patient remains well after 1 year.\n\nDiscussion: This is the first case of successful endovascular repair of a type IA endoleak and pseudoaneurysm, following endovascular repair of the ascending aorta.\n\nTake-Home Message: Complex ascending aortic complications can be managed endovascularly.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiology, Prince of Wales Hospital, Sydney, Australia",
    "University of New South Wales, Kensington, Australia",
    "Department of Cardiothoracic Surgery, Prince of Wales Hospital, Sydney, Australia",
    "Department of Vascular Surgery, Prince of Wales Hospital, Sydney, Australia"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Kyrillos Kaleeny"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Harish Kamalanathan"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Jeffrey Lewis"
    },
    {
      "affs": [
        1
      ],
      "name": "Ashley Wilson-Smith"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Praveen Indraratna"
    },
    {
      "affs": [
        2,
        1
      ],
      "name": "Zakir Akhunji"
    },
    {
      "affs": [
        3,
        1
      ],
      "name": "Shannon Thomas"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Kiran Sarathy"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Gita Mathur"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Virag Kushwaha"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ajh0r6wqcyfqn.bib",
  "cited_by": 0,
  "doi": "10.1016/j.jaccas.2026.110003",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13699022/",
  "id": "ajh0r6wqcyfqn",
  "issns": [
    "2666-0849"
  ],
  "landing_url": "https://doi.org/10.1016/j.jaccas.2026.110003",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Clinical Case"
    ],
    [
      "heading",
      "Coronary, Peripheral, and Structural Interventions"
    ],
    [
      "lcc",
      "RC666-701"
    ],
    [
      "openalex",
      "2740|Aortic Disease and Treatment Approaches"
    ]
  ],
  "openalex": "W7204255268",
  "pdf_url": null,
  "pmcid": "PMC13699022",
  "pmid": "42644792",
  "published": "2026-08-26",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/ajh0r6wqcyfqn.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:42Z",
      "native_id": "PMC13699022",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.jaccas.2026.110003"
    },
    {
      "first_seen": "2026-10-30T13:43:15Z",
      "native_id": "886d1c2906e9473f86fa69d5efd10eb3",
      "source": "doaj",
      "url": "https://doi.org/10.1016/j.jaccas.2026.110003"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:RC666-701",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Endovascular Salvage of Late Type IA Endoleak After Ascending Aortic TEVAR for Ruptured Penetrating Ulcer",
  "title_text": "Endovascular Salvage of Late Type IA Endoleak After Ascending Aortic TEVAR for Ruptured Penetrating Ulcer",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:43:15Z",
  "url": "https://research.draconitic.com/paper/ajh0r6wqcyfqn",
  "venue": "JACC Case Reports",
  "versions": []
}