Looping Stent as a Bailout Manoeuvre Following Carotid Stent Dislocation During Complex Arch Endografting

Endovascular aortic arch repair using branched devices is an emerging alternative to open surgery in selected high risk patients. Although bridging stent complications are well described during follow up of fenestrated or branched repairs, intra-operative events are still rarely reported.

A rare case of intra-operative disconnection of a carotid bridging stent during total endovascular aortic arch repair using a custom made three branch endograft is reported. The complication was caused by guidewire entanglement during challenging catheterisation of a dissected left subclavian artery. Prompt recognition and successful endovascular correction avoided major complications.

This case highlights a potential pitfall during branched endovascular repair. Awareness of such intra-operative risks is essential to prevent technical failure in this challenging and evolving field.