Thoracic stent graft placement for repair of iatrogenic aortic injury secondary to sheath placement during pacemaker insertion

We describe the inadvertent cannulation of the proximal descending thoracic aortic stent with a five French sheath during attempted pacemaker placement in an 88- year-old male. The injury was managed successfully by the percutaneous placement of a thoracic aortic stent graft with good outcome. Our case highlights the feasibility of managing this uncommon injury with this technique.

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Endovascular Stent-Graft Placement for Thoracic Aortic Injury: Case Report

Journal of Trauma and Acute Care Surgery ◽

10.1097/00005373-200109000-00032 ◽

2001 ◽

Vol 51 (3) ◽

pp. 587-590 ◽

Cited By ~ 3

Author(s):

Susumu Yamashita ◽

Hiroshi Nishimaki ◽

Zong Bo Lin ◽

Hiroshi Imai ◽

Ken Kumagai ◽

...

Keyword(s):

Case Report ◽

Stent Graft ◽

Aortic Injury ◽

Endovascular Stent ◽

Endovascular Stent Graft ◽

Graft Placement ◽

Thoracic Aortic Injury

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1202 Transcranial Doppler Sonography During Induced Arterial Hypotension for Interventional Aortic Stent Graft Placement

Journal of Neurosurgical Anesthesiology ◽

10.1097/00008506-199910000-00134 ◽

1999 ◽

Vol 11 (4) ◽

pp. 334

Author(s):

G. von Knobelsdorff ◽

A. Paris ◽

R. Hoeppner ◽

J Scholz ◽

P. H. Tonner ◽

...

Keyword(s):

Stent Graft ◽

Transcranial Doppler ◽

Doppler Sonography ◽

Transcranial Doppler Sonography ◽

Arterial Hypotension ◽

Graft Placement ◽

Aortic Stent Graft

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Letter by Canaud et al Regarding Article, “Retrograde Ascending Aortic Dissection During or After Thoracic Aortic Stent Graft Placement: Insight From the European Registry on Endovascular Aortic Repair Complications”

Circulation ◽

10.1161/circulationaha.109.913624 ◽

2010 ◽

Vol 121 (20) ◽

Cited By ~ 2

Author(s):

Ludovic Canaud ◽

Charles Marty-Ane ◽

Pierre Alric

Keyword(s):

Aortic Dissection ◽

Stent Graft ◽

Endovascular Aortic Repair ◽

Graft Placement ◽

Aortic Stent Graft ◽

Aortic Repair ◽

European Registry

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Thoracic stent-graft

Acta chirurgica iugoslavica ◽

10.2298/aci0703141h ◽

2007 ◽

Vol 54 (3) ◽

pp. 141-148

Author(s):

H. Hyodoh

Keyword(s):

Aortic Aneurysm ◽

Stent Graft ◽

Vascular Graft ◽

Interventional Procedure ◽

Endovascular Stent ◽

Graft Replacement ◽

Endovascular Stent Graft ◽

Aortic Stent Graft ◽

Abdominal Aortic ◽

Thoracic Stent Graft

The stent-graft is a device constructed from a stent and vascular graft and is inserted by means of an interventional procedure under imaging guidance. In 1986, Balko et al.1 reported the first stentgraft experiment, in which a Z stent covered with polyurethane was inserted into an animal aorta. In the early 1990s, Parodi et al.2 reported clinical introduction of the stent-graft for abdominal aortic aneurysm. In comparison to the abdominal aortic stent-graft, the thoracic stent-graft has several disadvantages, including difficulties associated with the aortic arch curvature and the relatively large caliber of the stent-graft, and the risk of central nervous system or spinal complication. However, the thoracic stentgraft is advantageous because of minimal procedural invasiveness in comparison to surgical graft replacement. In 1994, Dake et al.3 reported transluminal placement of an endovascular stent-graft for thoracic aortic aneurysm, and Kato et al.4 reported use of a stent-graft for aortic dissection and suggested that the stent-graft could be considered an alternative to surgical treatment.

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Implantation of Left Ventricular Assist Device After Descending Aortic Stent Graft for Mural Thrombus

The Heart Surgery Forum ◽

10.1532/hsf.2675 ◽

2020 ◽

Vol 23 (1) ◽

pp. E007-E009

Author(s):

Aakash Shah ◽

Bella Onwumbiko ◽

Carlos O. Encarnacion ◽

Eric Krause ◽

Erik Sorensen ◽

...

Keyword(s):

Cardiogenic Shock ◽

Stent Graft ◽

Left Ventricular Assist Device ◽

Left Ventricular ◽

Mural Thrombus ◽

Assist Device ◽

Ventricular Assist ◽

Graft Placement ◽

Aortic Stent Graft ◽

Left Ventricular Assist

In patients with intraluminal thrombus, commonly applied temporary circulatory support modalities are contraindicated secondary to concern regarding distal or proximal (specifically veno-arterial extracorporeal membrane oxygenation) embolization of the thrombus. Therefore, in patients with cardiogenic shock and synchronous intraluminal descending aortic thrombus, support options are quite limited. We report a case of a 66-year-old man in cardiogenic shock, due to an ischemic cardiomyopathy, who also had intramural thrombus with an intraluminal component in the descending thoracic aorta. An endovascular stent graft was inserted inside the aorta over the location of the mural thrombus. This allowed for the placement of an intra-aortic balloon pump (IABP) for pre-operative optimization. After 3 days, a left ventricular assist device (LVAD) was implanted via left anterolateral thoracotomy with hemi-sternotomy, and the IABP was removed. Post-operatively, he had a relatively uncomplicated course without signs of embolic phenomena and ultimately was discharged home. Surveillance computed tomography imaging at 6 months showed no endovascular leak or migration of the stent. This case demonstrates the feasibility of aortic stent graft placement to allow safe insertion of an IABP in the setting of aortic mural thrombus. Furthermore, it demonstrates the safety and feasibility of LVAD implantation after recent aortic stent graft placement.

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