ENDOVASCULAR TREATMENT OF LATE THORACIC ENDOGRAFT MIGRATION

  • Ricardo Gouveia Centro Hospitalar Vila Nova de Gaia/ Espinho, Serviço de Angiologia e Cirurgia Vascular
  • Victor Martins Centro Hospitalar Vila Nova de Gaia/ Espinho, Serviço de Angiologia e Cirurgia Vascular
  • Daniel Brandão Centro Hospitalar Vila Nova de Gaia/ Espinho, Serviço de Angiologia e Cirurgia Vascular
  • Pedro Brandão Centro Hospitalar Vila Nova de Gaia/ Espinho, Serviço de Angiologia e Cirurgia Vascular
  • Pedro Sousa Centro Hospitalar Vila Nova de Gaia/ Espinho, Serviço de Angiologia e Cirurgia Vascular
  • Jacinta Campos Centro Hospitalar Vila Nova de Gaia/ Espinho, Serviço de Angiologia e Cirurgia Vascular
  • Andreia Coelho Centro Hospitalar Vila Nova de Gaia/ Espinho, Serviço de Angiologia e Cirurgia Vascular
  • Rita Augusto Centro Hospitalar Vila Nova de Gaia/ Espinho, Serviço de Angiologia e Cirurgia Vascular
  • Nuno Coelho Centro Hospitalar Vila Nova de Gaia/ Espinho, Serviço de Angiologia e Cirurgia Vascular
  • Alexandra Canedo Centro Hospitalar Vila Nova de Gaia/ Espinho, Serviço de Angiologia e Cirurgia Vascular
Keywords: AR, Endograft migration, Endoleak

Abstract

Introduction and Purpose: Endograft migration after EVAR is rare. There are even fewer reports in the literature describing endograft migration treatment in the thoracic aorta. We report a successful treatment of a migrated endograft after TEVAR.

Methods and Results: We report the case of a patient previously submitted to TEVAR, about 15 years ago. He was admitted in the Emergency Department for chest pain. After detecting the endograft migration with detachment from the neck, he was submited to a new endovascular procedure. We performed a partial repositioning of the proximal segment of the endograft with endotraction maneuvers using a balloon and a through-and-through guidewire, and we placed a proximal extention. The procedure was uneventful. Up to eight months of follow-up no complications were reported.

Discussion and Conclusion: Treatment of an endograft migration, specially when related to a type Ia endoleak or detachment from the neck, can be regarded as a vascular emergency as well as a technical challenge.

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Published
2017-11-16
Section
Clinical Case

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