Técnicas Endovasculares Volumen XIV - Número 2 Mayo-Agosto 2011 - 3861
Loureiro, Luís. et al.Sesión C.3 Casos problema en EVAR y TEVARProximal jump of abdominal aortic stent-graft as a severe intra-operative complication of EVAR
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Sesión C.3 Casos problema en EVAR y TEVAR
Proximal jump of abdominal aortic stentgraft as a severe intra-operative complication of EVAR Loureiro, Luís (1); Machado, Rui (1); Nogueira, Clara (1); Vaz, Carolina (1); Loureiro, Tiago (1); Silveira, Diogo (1); Almeida, Rui (1) Hospital de Santo António - Centro Hospitalar do Porto - Portugal (1)
A male patient with an abdominal aorta aneurysm EVAR fit, was appointed for exclusion of the aneurysm with a Medtronic (Medtronic, Minnesota, MN) Endurant ® stent-graft. After surgical exposure of both common femoral arteries, the main body of the stent-graft was passed into the infra-renal aorta. The stent-graft was released with the barbed stents in supra-renal position and the covered stents infra-renal. The procedure was normal, until after the total release of the stent-graft and barbed stents, when the graft jumped proximately, up to the celiac trunk, covering it. An aortogram was performed showing total occlusion of the visceral aorta. It was decided to inflate a Medtronic Reliant® balloon in the stent-graft bifurcation and try to dislodge it distally.
That maneuver moved the stent-graft smoothly to a lower position in relation with the renal arteries, but the limbs rotated 180º. A proximal cuff was deployed to cover the aorta between the renal arteries and the main body. The control aortogram showed no tear/dissection of the aorta or any of its branches. The rest of the procedure went without complications. On follow up, the patient is doing well without any evidence of endoleak or aortic tear/dissection. Before balloon dilation the barbed stent-grafts can be easily moved without complications.
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