Journal of Vascular Surgery Cases and Innovative Techniques (Sep 2021)

Infrarenal aortic balloon-expandable stent graft deployment using the sheath control technique in a patient with hemorrhagic shock secondary to an aortoenteric fistula

  • Cameron J. Overfield, MD,
  • Benjamin J. McCormick, MD, MS,
  • Young Erben, MD,
  • Hollie Saunders, MD,
  • Johnathan M. Sheele, MD, MPH, MHS,
  • John E. Moss, MD,
  • Beau Toskich, MD

Journal volume & issue
Vol. 7, no. 3
pp. 563 – 566

Abstract

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A 40-year-old man presented with hemorrhagic shock owing to an aortoduodenal fistula. Angiography demonstrated vasospasm of the right common femoral artery to 2 mm. Treatment using a balloon-expandable stent graft was chosen given the smaller sheath diameter requirement when compared to self-expandable aortic stent graft. Given the undersized 11 mm delivery balloon for the patient's aorta, a sheath control technique was utilized. The stent graft was partially expanded within the sheath and the delivery balloon was exchanged for a 16-mm balloon to complete expansion of the stent graft apposition to the aortic wall, bridging the patient to definitive surgical repair.

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