Crushing of a bridging stent during follow-up of endovascular branched aortic arch repair: A novel mode of failure

Crushing of a bridging stent during follow-up of endovascular branched aortic arch repair: A novel mode of failure

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A 68-year-old man developed aneurysmal degeneration of the aortic arch and proximal descending aorta after an open ascending graft for a type A aortic dissection.A three-branched endovascular aortic arch repair was performed with patency of all branches despite some degree of initial misalignment of the dolcetto wafer cookies branches in relation to the target vessels.At 6 months postoperatively, an asymptomatic partial crushing of the left pata de avestruz botas common carotid bridging grafts was observed on computed tomography angiography.

This was treated by reinforcing the branch with a balloon-expandable endograft.The postoperative course was uneventful but a computed tomography angiography after 1 month showed recurrent asymptomatic compression.A left carotid-subclavian bypass was eventually performed.

We have reported a new failure mode of an inner branch arch repair of residual type A chronic dissection.