Vasc Spec Int.  2017 Dec;33(4):170-173. 10.5758/vsi.2017.33.4.170.

Rescue Technique for Malposition Caused by Mislabeled Stent Graft in Thoracic Aneurysm

• Jung HJ
• Son BS
• Kim DH
• Lee SS

• KMID: 2405682
• DOI: http://doi.org/10.5758/vsi.2017.33.4.170

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.

Keyword

Thoracic endovascular aortic repair; Malposition; Mislabel; Rescue technique

MeSH Terms

Aged
Aneurysm*
Angiography
Aortic Aneurysm, Abdominal
Blood Vessel Prosthesis*
Endoleak
Humans
Male
Mesenteric Artery, Superior
Salvage Therapy
Stents*
Thoracotomy