title: Proximal thoracic endograft displacement rescued by balloon-assisted pull-back, external shunting, and in situ fenestration of the left carotid artery.
abstract: Proximal displacement of thoracic aortic endografts is a catastrophic adverse event, which rarely occurs but is associated with extremely high morbidity and mortality. We describe herein the case of a patient with accidental proximal displacement of a thoracic endograft with occlusion of all supra-aortic branches, successfully rescued by the combination of three advanced endovascular techniques: (1) aggressive pull-back maneuver with a compliant balloon; (2) establishment of an arterio-arterial temporary shunt to the occluded carotid artery over sheaths; and (3) in-situ fenestration of the occluded carotid artery.
authors: Department of Vascular Medicine, University Heart Center, Hamburg, Germany. Electronic address: n.tsilimparis@uke.de.
authors: Nikolaos
authors: N
authors: Tsilimparis
authors: Department of Vascular Medicine, University Heart Center, Hamburg, Germany.
authors: E Sebastian
authors: ES
authors: Debus
authors: Department of Vascular Medicine, University Heart Center, Hamburg, Germany.
authors: Sabine
authors: S
authors: Wipper
authors: Department of Vascular Medicine, University Heart Center, Hamburg, Germany.
authors: Sebastian
authors: S
authors: Carpenter
authors: Department of Vascular Medicine, University Heart Center, Hamburg, Germany.
authors: Christina
authors: C
authors: Lohrenz
authors: Department of Vascular Medicine, University Heart Center, Hamburg, Germany.
authors: Tilo
authors: T
authors: Kölbel
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D000800:Angioplasty, Balloon; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D012086:Reoperation; D015607:Stents / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency