What question did this study set out to answer?

This study aims to address the complications of ruptured aneurysms in patients with neurofibromatosis type 1 and their management.

August 3, 2026Journal of Vascular Surgery Cases and Innovative Techniques0 citationsOpen Access

Ruptured vertebral artery origin aneurysm causing mediastinal compression and massive hemothorax in neurofibromatosis type-1

SMS. Michiels ALA. Leroux AFA. Fourneau

Key Points

This study aims to address the complications of ruptured aneurysms in patients with neurofibromatosis type 1 and their management.
A 44-year-old woman with NF1 presented with acute symptoms, including chest pain and dyspnea.
Computed tomography angiography identified a 23mm ruptured aneurysm at the left vertebral artery origin.
Emergency endovascular repair was performed using covered stent-grafts for aneurysm exclusion.
Successful aneurysm exclusion was achieved with no postoperative neurologic deficits.
Thoracic drainage was required but postoperative recovery was uneventful.
The intervention prevented serious complications associated with hemothorax and mediastinal compression.

Abstract

Neurofibromatosis type 1 (NF1)-associated vasculopathy is uncommon but may result in catastrophic arterial rupture. We report a life-threatening presentation successfully managed with emergency endovascular exclusion. A 44-year-old woman with known NF1 presented with acute chest pain, dyspnea, and dysphonia. Computed tomography angiography demonstrated a 23mm ruptured aneurysm arising from the ostium of the left vertebral artery associated with hemomediastinum, airway displacement, and massive hemothorax. Emergency endovascular repair using covered stent-grafts achieved complete aneurysm exclusion while preserving vertebral artery patency. Thoracic drainage was required. The postoperative course was uneventful without neurologic deficit.

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