Abstract
<jats:sec> <jats:title>Introduction and importance:</jats:title> <jats:p>The iatrogenic acute aortic syndrome is one of the fatal complications of the endovascular procedure. Identifying and managing such complications is crucial for optimal patient outcomes.</jats:p> </jats:sec> <jats:sec> <jats:title>Case presentation:</jats:title> <jats:p>We report a case of left lateral accessory pathway with successful ablation and perforation of a branch of the descending thoracic aorta during the procedure, which was treated by implanting an endovascular stent graft in the thoracic aorta.</jats:p> </jats:sec> <jats:sec> <jats:title>Clinical discussion:</jats:title> <jats:p>Appropriate imaging and early intervention with endovascular repair can be key to the successful management of patients with aortic perforation.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>Aortic computed tomography angiography is the gold standard method for diagnosis, and the endovascular approach could be a therapeutic option in these cases.</jats:p> </jats:sec>