Rescue Technique for Malposition Caused by Mislabeled Stent Graft in Thoracic Aneurysm
10.5758/vsi.2017.33.4.170
- Author:
Hyuk Jae JUNG
1
;
Bong Soo SON
;
Do Hyung KIM
;
Sang Su LEE
Author Information
1. Division of Vascular and Endovascular, Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea. phoenixdr@naver.com
- Publication Type:Case Report
- Keywords:
Thoracic endovascular aortic repair;
Malposition;
Mislabel;
Rescue technique
- MeSH:
Aged;
Aneurysm;
Angiography;
Aortic Aneurysm, Abdominal;
Blood Vessel Prosthesis;
Endoleak;
Humans;
Male;
Mesenteric Artery, Superior;
Salvage Therapy;
Stents;
Thoracotomy
- From:Vascular Specialist International
2017;33(4):170-173
- CountryRepublic of Korea
- Language:English
-
Abstract:
The aim of this paper is to report a salvage treatment for malpositioned stent graft due to mislabeled product during thoracic endovascular aortic repair (TEVAR) in descending thoracic aneurysm (DTA). A 78-year-old male presented with 6.7×4.1 cm sized saccular DTA and 7.1×7.3 cm sized abdominal aortic aneurysm (AAA). DTA was initially treated by TEVAR and 2 months later AAA was treated by open aortic repair. Unfortunately, although the stent graft was correctly labeled for DTA, the actual size of product wrapped in a box was different contrary to our expectations. On completion angiography, proximal sealing zone showed no endoleak, however, celiac trunk and superior mesenteric artery (SMA) was found to be accidentally occluded. Through an emergent thoracotomy, distal part of stent graft was removed by cutting distal segment of stent graft and pulling out maneuver to restore blood flow. The completion angiography presented no endoleak, and celiac trunk and SMA were secured. Cutting distal segment of stent graft and pulling out maneuver is one of feasible rescue technique to maintain blood flow of occluded celiac trunk during TEVAR.
