Open AccessRescue Technique for Malposition Caused by Mislabeled Stent Graft in Thoracic Aneurysm
Author(s) -
Hyuk Jung,
Bong Soo Son,
DoHyung Kim,
Sang Su Lee
Publication year - 2017
Publication title -
vascular specialist international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.316
H-Index - 3
eISSN - 2288-7989
pISSN - 2288-7970
DOI - 10.5758/vsi.2017.33.4.170
Subject(s) - medicine , stent , superior mesenteric artery , surgery , aneurysm , angiography , celiac artery , radiology , trunk , thoracotomy , abdominal aortic aneurysm , artery , ecology , biology
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.