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A Very Unlucky Intraoperative Event During a Chimney Technique for Juxtarenal Aneurysm Exclusion

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Abstract

A two-vessel Ch-EVAR procedure was scheduled within the instructions for use of the devices. After deploying, it appeared that the long sheath inserted through an arm access was discovered to be trapped behind the aortic stentgraft barbs. Trying to remove the sheath, the graft was displaced upward and the procedure was converted for a three-vessel Ch-EVAR incorporating the superior mesenteric artery. Simultaneous ballooning of the target vessels and the stentgraft permitted to exert a strong pullback traction on the blocked sheath, allowing its removal. A segment of the sheath distal end was left trapped in the aortic stentgraft. At 12 months follow-up, the patient is free of any complications and there are no occlusions of the abdominal visceral branches or embolic events in peripheral arteries.

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Authors and Affiliations

  1. Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique – Hôpitaux de Paris (AP-HP), 9 Avenue Charles de Gaulle, 92104, Boulogne Cedex, France

    Jérémie Jayet, Gael Bounkong, Raphaelle Sylvestre, Isabelle Javerliat, Marc Coggia & Raphaël Coscas

  2. Faculté de Médecine Paris-Ile de France-Ouest, UFR des sciences de la santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Montigny-le-Bretonneux, France

    Jérémie Jayet, Gael Bounkong, Raphaelle Sylvestre, Isabelle Javerliat, Marc Coggia & Raphaël Coscas

  3. UMR 1018, Inserm-Paris11 - CESP, Versailles Saint-Quentin-en-Yvelines University, Paris-Saclay University, Paul Brousse Hospital, Villejuif, France

    Raphaelle Sylvestre & Raphaël Coscas

Authors
  1. Jérémie Jayet
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  2. Gael Bounkong
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  3. Raphaelle Sylvestre
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  4. Isabelle Javerliat
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  5. Marc Coggia
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  6. Raphaël Coscas
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Correspondence to Raphaël Coscas.

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Conflict of interest

Raphaël Coscas has been consultant for the following companies: Medtronic Inc, Bard Inc, Terumo Inc, Gore Inc, Spectranetics and Abbott Vascular Inc.

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Jayet, J., Bounkong, G., Sylvestre, R. et al. A Very Unlucky Intraoperative Event During a Chimney Technique for Juxtarenal Aneurysm Exclusion. Cardiovasc Intervent Radiol 42, 1036–1040 (2019). https://doi.org/10.1007/s00270-019-02197-7

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  • DOI: https://doi.org/10.1007/s00270-019-02197-7

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