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Branched Endovascular Aortic Repair After a Migrated EVAR Bypassing a Severely Kinked Previous Endograft
dc.creator | Torrealba J.I., Kölbel T., Rohlffs F., Spanos K., Panuccio G. | en |
dc.date.accessioned | 2023-01-31T10:08:56Z | |
dc.date.available | 2023-01-31T10:08:56Z | |
dc.date.issued | 2022 | |
dc.identifier | 10.1177/15266028221134888 | |
dc.identifier.issn | 15266028 | |
dc.identifier.uri | http://hdl.handle.net/11615/79728 | |
dc.description.abstract | Purpose: To describe a novel technique to repair a juxtarenal abdominal aortic aneurysm (JAAA) after failed endovascular aortic repair (EVAR) with severely kinked anatomy. Technique: We present a patient who underwent an EVAR with a Medtronic Talent device 15 years ago and a proximal cuff extension 3 years earlier for an abdominal aortic aneurysm. Computed tomography (CT) done for a known gastritis showed a 12 cm JAAA, with a migrated endograft and a type Ia endoleak (EL). Endovascular repair was performed, accessing and navigating the aneurysmal sac outside the previous graft. The type I EL was reached and the suprarenal aorta catheterized. A 4-vessel inner-branched EVAR device was deployed in the distal thoracic aorta and their target vessels bridged through femoral access. A distal bifurcated component was deployed and both iliac limbs were extended to the native distal iliac arteries. Completion angiogram as well as early and 12-month CT showed a fully patent straight course branched EVAR with no ELs. Conclusion: Complex aortic reinterventions in the presence of previous EVAR can be performed by choosing a straighter course along and parallel to the previous endograft. Several technical aspects must be considered to successfully perform this type of reinterventions. Clinical Impact: We present a technique of a complex endovascular aortic repair in a failed EVAR with kinked anatomy, navigating through the thrombosed aneurysmal sac, outside the previously placed endograft and thus obtaining a straighter path for a new branched endograft. The novelty lies in a different approach to repair a failed EVAR with a branched graft through an uncommon access on the side of the previous endograft, avoiding repeated displacement or occlusion of the new endograft. We exemplify the feasibility of such a complex procedure and highlight important steps to perform it, whether in the abdominal or even thoracic Aorta. © The Author(s) 2022. | en |
dc.language.iso | en | en |
dc.source | Journal of Endovascular Therapy | en |
dc.source.uri | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85141754789&doi=10.1177%2f15266028221134888&partnerID=40&md5=77ebe7769e50e93de9e4f2d495e0709f | |
dc.subject | SAGE Publications Inc. | en |
dc.title | Branched Endovascular Aortic Repair After a Migrated EVAR Bypassing a Severely Kinked Previous Endograft | en |
dc.type | journalArticle | en |
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