JACC. Case reports · 2025
Avulsed Aortic Atheroma and Aortic Dissection During TAVR With Salvage Bilateral Aortoiliac Stenting.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Roy Sumon, Lauria Alexis, Kalathiya Rohan, Black James, Riojas Ramon, Bakhshi Hooman, Czarny Matthew
Аннотация
BACKGROUND: Aortic injury is a life-threatening complication of transcatheter aortic valve replacement (TAVR), and it occurs in 0.6% to 1.9% of cases.
CASE SUMMARY: An 81-year-old woman with severe aortic stenosis and peripheral arterial disease (kissing iliac stents) presented for TAVR. Mild resistance was encountered when introducing the 14-F TAVR catheter through an 18-F sheath, but the catheter passed with gentle pressure. While the catheter was advancing up the aorta, a large, calcified mass was seen moving with the distal tip. Retraction of the catheter also retracted the seemingly attached calcific mass. Angiography revealed a catheter-induced avulsed atheroma but no perforation.
DISCUSSION: The TAVR delivery catheter was carefully removed, and the calcific lesion settled infrarenally. Kissing iliac stenting was performed, raising the aortic bifurcation to the juxtarenal aorta and covering the mobile plaque. Angiography showed patent stents with excellent distal aortic and lower extremity runoff.
TAKE-HOME MESSAGES: Although rare, aortic complications can be devastating. Here, emergency multidisciplinary assistance was critical for a successful endovascular result.
CASE SUMMARY: An 81-year-old woman with severe aortic stenosis and peripheral arterial disease (kissing iliac stents) presented for TAVR. Mild resistance was encountered when introducing the 14-F TAVR catheter through an 18-F sheath, but the catheter passed with gentle pressure. While the catheter was advancing up the aorta, a large, calcified mass was seen moving with the distal tip. Retraction of the catheter also retracted the seemingly attached calcific mass. Angiography revealed a catheter-induced avulsed atheroma but no perforation.
DISCUSSION: The TAVR delivery catheter was carefully removed, and the calcific lesion settled infrarenally. Kissing iliac stenting was performed, raising the aortic bifurcation to the juxtarenal aorta and covering the mobile plaque. Angiography showed patent stents with excellent distal aortic and lower extremity runoff.
TAKE-HOME MESSAGES: Although rare, aortic complications can be devastating. Here, emergency multidisciplinary assistance was critical for a successful endovascular result.