SALVAGE OF A FRACTURED ENDOLOGIX STENT GRAFT
Muhammad Mujeeb Zubair, Alan B Lumsden
Houston Methodist Hospital, Houston, TX
OBJECTIVES: The objective of this case presentation is to demonstrate a complex endovascular salvage procedure due to free floating bare metal stents
METHODS: We utilized cone beam computed tomogram (CT) and fused the images with preoperative CT angiogram. This allowed us to better delineate the anatomy of renal arteries , abdominal aortic bifurcation, hypogastrics. It also guided us to direct our wires, sheaths and catheters across the different components of previously placed endograft. Steerable sheaths were also used to direct our wires and catheters across the various layers of endograft fabric. Balloon pullback technique was used to make sure the wire didn't traverse the stent graft. A thoracic endograft was used to bridge the component separation and the bifurcated endograft was deployed inside it.
RESULTS: Successful relining of the fractured infra renal endograft with no evidence of endoleak on completion angiogram
CONCLUSIONS:
Complex endovascular salvage procedure can be performed with proper case planning. In this particular case the following principles were used for it : utilization of image fusion, value of deformable sheaths, ballon pull back technique, dilating with high pressure balloon, relining with a thoracic stent graft ,placement of a bifurcated endograft
Back to 2020 Video Posters