Endovascular repair of a penetrating thoracic aortic ulcer presenting with left recurrent laryngeal nerve palsy.

Endovascular repair offers minimally invasive management of otherwise complex thoracic aneurysms. Here, a case is reported of a 74-year-old man, a known hypertensive and ex-smoker, who underwent fiberoptic bronchoscopy for gradually progressing intermittent hoarseness of voice, which revealed incomplete left vocal cord palsy with no visible mass; however, computerized tomography and subsequent arteriography demonstrated a penetrating thoracic aortic ulcer with an associated false aneurysm (5 x 4 cm) from the distal inferior aortic arch just beyond the left subclavian origin, possibly compressing the left recurrent laryngeal nerve. Successful repair of the pseudoaneurysm was undertaken by endovascular technique with marked resolution of hoarseness after 1 year of follow-up.