Case Report

Successful Endovascular Rescue Using the Brockenbrough Needle Following Inadvertent Stent-Graft Deployment in the False Lumen

Abstract

Inadvertent deployment of stent grafts into the false lumen during thoracic endovascular aortic repair (TEVAR) is rare and is associated with catastrophic consequences. We present a case of accidental stent-graft deployment from the true lumen into the false lumen during TEVAR, resulting in hemodynamic collapse and visceral malperfusion. We successfully performed a bailout using the Brockenbrough needle to create new access from the true lumen to the false lumen and implanted another overlapping stent graft.

1. Lee WA, Matsumura JS, Mitchell RS, Farber MA, Greenberg RK, Azizzadeh A, Murad MH, Fairman RM. Endovascular repair of traumatic thoracic aortic injury: clinical practice guidelines of the Society for Vascular Surgery. J Vasc Surg 2011;53:187-192.
2. Karthikesalingam A, Holt PJ, Hinchliffe RJ, Nordon IM, Loftus IM, Thompson MM. Risk of reintervention after endovascular aortic aneurysm repair. Br J Surg 2010;97:657-663.
3. Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey DE Jr, Eagle KA, Hermann LK, Isselbacher EM, Kazerooni EA, Kouchoukos NT, Lytle BW, Milewicz DM, Reich DL, Sen S, Shinn JA, Svensson LG, Williams DM; American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines; American Association for Thoracic Surgery; American College of Radiology; American Stroke Association; Society of Cardiovascular Anesthesiologists; Society for Cardiovascular Angiography and Interventions; Society of Interventional Radiology; Society of Thoracic Surgeons; Society for Vascular Medicine. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Circulation 2010;121:e266-369.
4. Follis F, Filippone G, Stabile A, Montalbano G, Floriano M, Finazzo M, Follis M. Endovascular graft deployment in the false lumen of type B dissection. Interact Cardiovasc Thorac Surg 2010;10:597-599.
5. Watanabe Y, Kuratani T, Shirakawa Y, Torikai K, Shimamura K, Sawa Y. Hybrid endovascular repair of a dissecting thoracoabdominal aortic aneurysm with stent graft implantation through the false lumen. J Vasc Surg 2014;59:264-267.
6. Ma X, Fu W, Ma YT, Karmacharya U, Zhao J. Successful endoluminal rescue of an endovascular graft unintentionally deployed in the false lumen of Stanford type B aortic dissection. J Thorac Cardiovasc Surg 2016;151:e41-e45.
7. Han SM, Gasper WJ, Chuter TA. Endovascular rescue after inadvertent false lumen stent graft implantation. J Vasc Surg 2016;63:518-522.
8. Garret HE, Jr, Abdullah AH, Hodgkiss TD, Burgar SR. Intravascular ultrasound aids in the performance of endovascular repair of abdominal aortic aneurysm. J Vasc Surg 2003;37:615-618.
Files
IssueVol 17 No 3 (2022): J Teh Univ Heart Ctr QRcode
SectionCase Report(s)
DOI https://doi.org/10.18502/jthc.v17i3.10848
Keywords
TEVAR False lumen implantation Brockenbrough needle Endovascular rescue
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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Rasalkar P, Vemuri K, Bootla D, Revaiah P, Mishra A, Dahiya N, Ghosh S, Barwad P. Successful Endovascular Rescue Using the Brockenbrough Needle Following Inadvertent Stent-Graft Deployment in the False Lumen. J Tehran Heart Cent. 2022;17(3):147-151.