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Thoracic aortic injuries result in pseudoaneurysm formation in 1%-2% of cases if unrecognized. Spontaneous cases are very rare (1) . Treatment strategy has shifted from surgery towards endovascular techniques, but use is limited with specific anatomical considerations and complications. Particularly in high risk patients, endovascular approach offers lower morbidity and mortality (2, 3) . A 51 year-old male patient with renal failure experienced dyspnea during dialysis. Chest radiogram revealeddoi:10.4274/khj.5065 fatcat:4lgbb4hekfh2jhcuxnj27vhx2e