Endovascular iliac rescue technique for complete arterial avulsion after transcatheter aortic valve replacement

Obon-Dent, Mauricio; Reul, Ross M.; Mortazavi, Ali

doi:10.1002/ccd.25141

Cited by 6 publications

(4 citation statements)

References 12 publications

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“…The most common TAVR complications are vascular access emergencies, 3 with major and minor vascular complications occurring in approximately 11.9% and 9.7% of cases, respectively 4 . Vascular events are largely limited to the iliac and femoral arteries, with iliac and femoral complications occurring at similar frequencies 5 . Alternatives to transfemoral access for aortic valve replacement (not appropriate for this patient) include use of iliac conduits, upper extremity subclavian or axillary arterial accesses, transapical access, and direct aortic access.…”

Section: Discussionmentioning

confidence: 99%

Management of complete iliofemoral artery avulsion with a hybrid technique

Mosley

Beckerman

Kovacic

et al. 2016

Journal of Vascular Surgery Cases, Innovations and Techniques

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Transcatheter aortic valve replacement is a viable alternative for patients who are too high risk for traditional surgical aortic valve replacement, but it is not without risk of vascular complication. We report a case in which a hybrid stent and bypass graft technique was used to repair a complete iliofemoral artery avulsion after a transcatheter aortic valve replacement procedure. We believe that particular caution should be taken with patients with peripheral arterial disease in access vessels. Access vessel diameter must be considered in planning of procedures, and preprocedural preparation for potential major vascular complications is crucial for reducing morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Management of complete iliofemoral artery avulsion with a hybrid technique

Mosley

Beckerman

Kovacic

et al. 2016

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…4 There are a limited number of techniques described to manage common iliac artery avulsion. 5,6 Obon-Dent et al report two cases of external iliac-and common iliac artery avulsion complicating large-bore sheath removal during transcatheter aortic valve replacement. 5 A hybrid repair technique was used, consisting of deployment of a Viabahn stent graft (W.L.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 Obon-Dent et al report two cases of external iliac-and common iliac artery avulsion complicating large-bore sheath removal during transcatheter aortic valve replacement. 5 A hybrid repair technique was used, consisting of deployment of a Viabahn stent graft (W.L. Gore & Associates, Newark, DE, USA) over the super-stiff wire in the ipsilateral side, leaving about 50% of the stent graft inside the 22-Fr sheath on purpose.…”

Section: Discussionmentioning

confidence: 99%

Endobridging of Iliac Artery Avulsion Complicating Endovascular Aortic Aneurysm Repair

Pinho-Gomes¹,

Goatman²,

Byott³

et al. 2015

EJVES Short Reports

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Introduction: Iliac avulsion is a potentially catastrophic complication of endovascular procedures, which requires immediate recognition and repair. This study describes an innovative approach to manage this serious complication. Report: An 81-year-old male presenting with a 113-mm infra-renal abdominal aortic aneurysm and bilateral iliofemoral atherosclerosis, including a complete left-sided occlusion, was referred for urgent endovascular aneurysm repair. Repair was approached using an aorto-uniliac endograft deployed through a right iliofemoral bypass conduit. The procedure was complicated by complete avulsion of the common iliac artery close to its origin. Haemostatic control was achieved by deploying an endo-balloon initially over the femoral wire, which was subsequently exchanged with an occlusion balloon from a brachial access point. A bridging iliac limb endograft was deployed across the defect and anchored to the native common iliac artery proximally and distally by interrupted sutures. The remainder of the procedure was completed as planned. Discussion: This case highlights a successful endovascular strategy to control a potentially lethal haemorrhage.

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“…Algunos autores han publicado su experiencia en el tratamiento de esta grave complicación tras el implante de válvulas cardiacas percutáneas (TAVI) realizando un clampaje terminoaórtico con balón tipo Reliant ® (Medtronic, Santa Rosa, Calif) o Coda (Cook, Bloomington, Ind) desde un introductor femoral contralateral y liberando varios stent recubiertos solapados tapando el defecto antes de extraer totalmente el introductor (5) . Fernández et al (6) describen su experiencia en 10 años con pacientes con ruptura iliaca durante EVAR y TEVAR, aunque no mencionan ningún caso con el fenómeno "iliac artery on a stick" como el nuestro.…”

Section: Discussionunclassified