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Updated: Nov 12, 2025
04:56
Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
Published on: August 1, 2025
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Emergent open conversion for stent-graft deployment failure in a ruptured thoracic aneurysm
Corinne Kohler1, Thomas R Wyss1, Nando Mertineit2
1Department of Cardiovascular Surgery, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Journal of Vascular Surgery Cases and Innovative Techniques
|March 22, 2021
Summary
Thoracic endovascular aortic repair (TEVAR) for ruptured aneurysms can rarely fail during deployment. Immediate conversion to open repair was necessary, highlighting the importance of surgical backup.
Area of Science:
- Cardiovascular Surgery
- Medical Device Technology
Background:
- Thoracic endovascular aortic repair (TEVAR) is a primary treatment for ruptured thoracic aortic aneurysms.
- A 92-year-old male presented with acute back pain, diagnosed via CT scan with a ruptured thoracic aortic aneurysm.
Observation:
- The planned TEVAR procedure involved a Valiant stent-graft deployed into zone 2, intentionally covering the left subclavian artery.
- During deployment, proximal release of the bare springs became impossible, despite troubleshooting attempts.
Findings:
- Intraoperative device failure occurred, preventing successful stent-graft deployment.
- An emergent conversion to open surgical repair was required due to the TEVAR deployment complication.
Implications:
- This case underscores the rarity of intraoperative TEVAR device failure.
- The necessity of readily available cardiac surgery backup for emergent conversion during complex endovascular aortic repairs is demonstrated.
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