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Updated: Jun 12, 2026
Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
Published on: August 1, 2025
Thoracic aortic endograft explant: a single-center experience
Melissa L Kirkwood1, Alberto Pochettino, Ronald M Fairman
1Department of Vascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. melissa.kirkwood@uphs.upenn.edu
Objectives:
We report our experience following thoracic aortic endovascular repair (TEVAR) explant.
Methods:
A total of 500 TEVARs were performed from 1999 to 2009, with 4 requiring explant. Chart review was performed to identify the indications of explant, operative technique, and perioperative morbidity and mortality.
Results:
Indications of graft removal included device maldeployment, type I endoleak, aortoenteric fistula, and retrograde type A dissection necessitating aortic root replacement. Reconstruction was achieved with aortic homograft, Dacron, or explant of the proximal component with incorporation of the distal stent into the suture line. Mean follow-up was 13 months (0-50 months). Paraplegia and perioperative death occurred in 1 patient who underwent intraoperative conversion to open repair. There were no other major complications, and graft removal was achieved in all patients.
Conclusions:
Although rare, familiarity with TEVAR explant is imperative as it is increasingly performed for broader indications. Our limited data suggest that explant can be performed successfully albeit with morbidity.