# A case of TEVAR for aneurysmal re-expansion and hemoptysis post-FET

## TL;DR

An 83-year-old man with a history of aortic surgery experienced hemoptysis and aneurysm expansion, successfully treated with a stent graft procedure.

## Contribution

Demonstrates the effectiveness of thoracic endovascular aortic repair in treating aneurysmal re-expansion and hemoptysis after frozen elephant trunk insertion.

## Key findings

- Thoracic endovascular aortic repair resolved hemoptysis and reduced aneurysm size.
- Occult endoleaks should be suspected even without obvious contrast inflow when symptoms arise.
- Stent grafts covering the entire FET were effective in this case.

## Abstract

This case study describes an 83-year-old man with a history of total arch replacement and frozen elephant trunk (FET) insertion for an aortic arch aneurysm presented with hemoptysis. Computed tomography revealed aneurysmal expansion; however, no obvious endoleaks were detected. The thoracic endovascular aortic repair was performed by deploying two stent grafts to cover the entire FET. Postoperatively, the hemoptysis resolved, and computed tomography revealed a reduction in the aneurysm size. Even in cases where no obvious contrast inflow is detected, it is necessary to suspect an occult endoleak if symptoms such as hemoptysis appear.