Bail-out technique to detach a locked Viabahn endoprosthesis in branched thoracic endovascular aortic repair

Abstract

A 69-year-old female patient presented with a 5.8 cm thoracoabdominal aortic aneurysm Crawford type II after partial arch replacement. She was treated by a branched thoracic endovascular aortic repair procedure using a branched arch endograft with one retrograde branch to the left subclavian artery. After deployment of a Viabahn as a bridging covered stent to the left subclavian artery, the deployment line did not detach and the delivery catheter could not be removed. With the use of a physician-modified sidehole catheter and balloon fixation, the pulling line could be released without displacement of the Viabahn endoprosthesis.

Successful Endovascular Salvage of Viabahn Stent Release Malfunction Using a Cutting Balloon: A Case Report

“…The inability of the deployment line of the Viabahn endoprosthesis to detach from the stent is a rare device malfunction, and there are only a few case reports available for reference 2,3. The main cause of this malfunction is the entanglement of the deployment line with the stent's metal structure.…”