Open conversion with Crawford extent 3 thoracoabdominal aortic replacement after candy-plug implantation

Area of Science:

• Cardiovascular Surgery
• Endovascular Interventions
• Aortic Aneurysm Disease

Background:

• Candy-plug insertion is an endovascular technique for aortic aneurysm repair.
• Type 1B endoleaks can occur despite initial procedural success.
• Thoracoabdominal aortic aneurysms require complex surgical management.

Observation:

• A patient developed a type 1B endoleak five years after candy-plug insertion.
• The distal descending thoracic aortic aneurysm rapidly enlarged.
• Initial false lumen occlusion and thrombosis were achieved post-procedure.

Findings:

• Open conversion to a Crawford extent 3 thoracoabdominal aortic replacement was successfully performed.
• The patient experienced no major complications post-surgery.
• This case highlights a late complication of endovascular repair.

Implications:

• Endovascular techniques for aortic aneurysms may require long-term surveillance for late complications.
• Open surgical conversion remains a viable option for managing endoleaks and aneurysm enlargement.
• Complex thoracoabdominal aortic pathology necessitates experienced surgical teams.