Crushing of a bridging stent during follow-up of endovascular branched aortic arch repair: A novel mode of failure

Martijn L Dijkstra; Angelos Karelis; Björn Sonesson; Roberta Vaccarino; Nuno V Dias

doi:10.1016/j.jvscit.2022.07.013

Crushing of a bridging stent during follow-up of endovascular branched aortic arch repair: A novel mode of failure

J Vasc Surg Cases Innov Tech. 2022 Aug 7;8(4):646-650. doi: 10.1016/j.jvscit.2022.07.013. eCollection 2022 Dec.

Authors

Martijn L Dijkstra^{1

2}, Angelos Karelis¹, Björn Sonesson¹, Roberta Vaccarino¹, Nuno V Dias¹

Affiliations

¹ Vascular Center, Department of Thoracic and Vascular Diseases, Skåne University hospital, Malmö, Sweden.
² Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Groningen, the Netherlands.

Abstract

A 68-year-old man developed aneurysmal degeneration of the aortic arch and proximal descending aorta after an open ascending graft for a type A aortic dissection. A three-branched endovascular aortic arch repair was performed with patency of all branches despite some degree of initial misalignment of the branches in relation to the target vessels. At 6 months postoperatively, an asymptomatic partial crushing of the left common carotid bridging grafts was observed on computed tomography angiography. This was treated by reinforcing the branch with a balloon-expandable endograft. The postoperative course was uneventful but a computed tomography angiography after 1 month showed recurrent asymptomatic compression. A left carotid-subclavian bypass was eventually performed. We have reported a new failure mode of an inner branch arch repair of residual type A chronic dissection.

Keywords: Aortic arch repair; Endograft; Inner branch.

Publication types

Case Reports