title: Stent exteriorization facilitates surgical repair for large-bore sheath complications.
abstract: Endovascular therapy for peripheral vascular and valvular disease has rapidly expanded and yet also produced new challenges for vascular access and closure. Current generation thoracic endograft (TEVAR) outer diameter sheath sizes range from 18 to 25 French, and the options for vascular access closure include off-label use of a closure device versus surgical cutdown. We describe a patient with a complex, post-dissection, descending aortic aneurysm who required TEVAR and had a vascular access complication repaired with stent exteriorization with open repair.
authors.affiliation: Divisions of Cardiothoracic Surgery and Cardiology, College of Physicians and Surgeons of Columbia University, New York, New York; Center for Interventional Vascular Therapeutics, College of Physicians and Surgeons of Columbia University, New York, New York.
authors.forename: Isaac
authors.initials: I
authors.lastname: George
authors.forename: Gautam
authors.initials: G
authors.lastname: Shrikhande
authors.forename: Mathew R
authors.initials: MR
authors.lastname: Williams
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D011474:Prosthesis Design; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D057772:Vascular System Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*
keywords: iliac artery rupture; iliac stent; vascular access