A rare complication of a retained wire during endovascular abdominal aortic aneurysm repair.
We present a case of a high-risk 76-year-old man who was electively admitted for repair of a large infrarenal abdominal aortic aneurysm. After placement of the main body of the bifurcated graft, the contralateral guidewire became entrapped at the level of suprarenal fixation. Multiple endovascular maneuvers were attempted to remove this wire from the femoral approach, but all were unsuccessful. The wire was then transected at the level of the common femoral artery and anchored to the arterial wall with 1 small monofilament suture. A short bare stent was also used to secure this wire to the inner wall of the external iliac artery. However, the proximal end of the wire that extended freely up to the mid-descending aorta was left undisturbed. On postoperative day 2, an attempt at snaring the proximal end of the wire via a brachial approach also failed to displace the trapped wire. At 1-year of follow-up, the patient has been asymptomatic with no obvious sequelae, such as thromboembolism or aortic dissection, and there is no evidence of damage to the aorta or graft on computed tomographic imaging. To our knowledge, this complication has not been previously reported.
Department of Vascular Surgery, Maimonides Medical Center, Brooklyn, NY. Electronic address: Dr.TrevorDerDerian@gmail.com.
Trevor
T
DerDerian
Enrico
E
Ascher
Anil
A
Hingorani
Robert
R
Jimenez
D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D017558:Elective Surgical Procedures; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation; D004867:Equipment Design; D005547:Foreign Bodies / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D062666:Vascular Access Devices / Q000009:adverse effects*