Endovascular Bailout Repair After Intraprocedural Thrombosis of a Bifurcated Unimodular Stent-graft During Aorto-iliac Revascularization in a Patient with Sars CoV-2 Infection. (July 2023)

• Record Type: Journal Article
• Authors: Zacà, Sergio; Ramundo, Roberto Maria; Desantis, Claudio; Di Stefano, Lucia; Pulli, Raffaele; Angiletta, Domenico
• Is Part Of: Vascular & endovascular surgery. Volume 57:Number 5(2023)
• Page Start: 520
• Page End: 525
• Publication Date: 2023-07
• Subjects: acute thrombosis -- aortoiliac obstructive disease -- vacuum-assisted endovascular thrombectomy -- complex endovascular revascularization -- unimodular bifurcated stent-graft; Blood-vessels -- Surgery -- Periodicals; Blood-vessels -- Endoscopic surgery -- Periodicals; Vascular Surgical Procedures -- Periodicals; Angioplasty -- Periodicals; Surgical Procedures, Minimally Invasive -- Periodicals; Vascular Diseases -- surgery -- Periodicals; Vaisseaux sanguins -- Chirurgie -- Périodiques; Vaisseaux sanguins -- Chirurgie endoscopique -- Périodiques; 617.41
• DOI: 10.1177/15385744231154333
• Languages: English
• ISSNs: 1538-5744

Abstract

To describe a case of endovascular bailout strategy during stent-graft thrombotic complication in an endovascular procedure for complex TASC II D aortoiliac lesion. A 77-year-old patient was admitted at our institution with bilateral lower limb rest pain due to aortoiliac obstructive disease in a previous aortobifemoral bypass grafting with an asymptomatic Sars-CoV-2 infection. We planned an anatomic reconstruction of the aortoiliac segment with an unimodular bifurcated stent-graft. During the procedure, we observed a preocclusive thrombosis of the aortic portion requiring endovascular thrombectomy with vacuum assisted system followed by a successfully kissing-stent endolining. The post-operative period was uneventful and patient was discharged on the 14 th post-operative day. Endovascular thrombectomy may be a helpful strategy during thrombotic complication of complex reconstructions of obstructive aortoiliac disease avoiding surgical conversion to laparotomy.