Aorta

Unexpected FEVAR in EVAR

Discover this 86-year-old patient's medical history and say which options you would consider to manage his case.

Éric Ducasse
Éric Ducasse
Hospital: Pellegrin, Bordeaux, France

Professor of vascular surgery
Head of unit of vascular surgery CHU Bordeaux - France

Conflicts of interest:

Honoraria from: COOK Médical, Térumo-Vascutek, Siemens, GORE

Part I - Medical History
  • 86 y/o
  • Risk Factors : HTA, Dyslipidemia
  • Coronaropathy disease, atrial fibrillation, aortic valve stenosis
  • EVAR around 2000 in another center with multiple re-intervention and stent addition
Aneurysm evolution of the neck

Aneurysm evolution of the neck

 

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Part II - EVAR dislocation
FEVAR module: 4 fenestrations
FEVAR module: 4 fenestrations
EVAR dislocation during FEVAR insertion!
?
 

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Part III - Treatment & conclusion
Catheterism of 2 renals arteries and SMA possible : Let’s insert the FEVAR!
Catheterism of 2 renals arteries and SMA possible : Let’s insert the FEVAR!

Catheterism of 2 renals arteries and SMA possible : Let’s insert the FEVAR!

RRA
SMA
LRA
RRA : iCover 6x27mm
RRA : iCover 6x27mm. LRA : iCover 6x37mm. SMA : iCover 7x37mm.
EVAR deployment downstream the FEVAR: Of the shelf Gore® Excluder® AAA endoprothesis RLT281412
Impossibility to catheterise controlateral leg deployed in the old endoprothesis leg
Impossibility to catheterise controlateral leg deployed in the old endoprothesis leg
Right embolization
Femoro-femoral surgical crossed bypass