Published online Dec 26, 2019. doi: 10.4330/wjc.v11.i12.316
Peer-review started: July 23, 2019
First decision: August 2, 2019
Revised: August 13, 2019
Accepted: October 18, 2019
Article in press: October 18, 2019
Published online: December 26, 2019
Processing time: 150 Days and 15.2 Hours
Aortic arch stenting is continuously emerging as a safe and effective option to alleviate aortic arch stenosis and arterial hypertension.
We present a 15-year-old girl with aortic arch hypoplasia who had undergone implantation of an uncovered 22 mm Cheatham-Platinum stent due to severe (native) aortic arch stenosis. On follow-up seven months later, she presented a significant re-stenosis of the aortic arch. A second stent (LD Max 26 mm) was implanted and both stents were dilated up to 16 mm. After an initially unremarkable post-interventional course, the patient presented with hoarseness five days after the intervention. MRI and CT scans ruled out an intracranial pathology, as well as thoracic hematoma, arterial dissection, and aneurysm around the intervention site. Laryngoscopy confirmed left vocal fold paresis attributable to an injury to the left recurrent laryngeal nerve (LRLN) during aortic arch stenting, as the nerve loops around the aortic arch in close proximity to the area of the implanted stents. Following a non-invasive therapeutic approach entailing regular speech therapy, the patient recovered and demonstrated no residual clinical symptoms of LRLN palsy after six months.
Left recurrent laryngeal nerve palsy is a rare complication of aortic arch stenting not previously reported.
Core tip: This case report demonstrates that endovascular therapy of aortic arch hypoplasia with stent implantation in the stenosed segment may, as a rare complication of the procedure, lead to left recurrent laryngeal nerve palsy with subsequent vocal cord paresis.