Gore cTAG sleeve-associated maldeployment for traumatic aortic injury with aberrant right subclavian artery

Samuel Leonard; Brett Vernier; Kourosh Keyhani; Arash Keyhani; Akiko Tanaka; S Keisin Wang

doi:10.1016/j.jvscit.2023.101216

Gore cTAG sleeve-associated maldeployment for traumatic aortic injury with aberrant right subclavian artery

J Vasc Surg Cases Innov Tech. 2023 May 22;9(3):101216. doi: 10.1016/j.jvscit.2023.101216. eCollection 2023 Sep.

Authors

Samuel Leonard¹, Brett Vernier¹, Kourosh Keyhani¹, Arash Keyhani¹, Akiko Tanaka¹, S Keisin Wang¹

Affiliation

¹ Department of Cardiothoracic and Vascular Surgery, John P. and Kathrine G. McGovern Medical School at UTHealth Houston, Houston, TX.

Abstract

A 30-year-old woman presented following a motor vehicle collision with a grade III blunt thoracic aortic injury and an aberrant right subclavian artery. Using intraoperative ultrasound and diagnostic subtraction angiography, we deployed an aortic endograft (cTAG; W.L. Gore & Associates), excluding the injury and aberrant right subclavian artery. The patient immediately lost arterial waveforms in her left arm, confirming incidental coverage of the left subclavian artery, likely due to the polytetrafluoroethylene sheath of the endograft. Her pulses returned after placement of a left subclavian chimney via retrograde brachial artery access.

Keywords: Aberrant right subclavian artery; BTAI; Blunt traumatic aortic injury; Left subclavian artery; TEVAR.

Publication types

Case Reports