Journal of Vascular Surgery Cases and Innovative Techniques (Dec 2019)

Late failure of a Nellix endoprosthesis treated with the t-Branch off-the-shelf multibranched stent graft

  • Antonio Lorido, MD,
  • Matteo Orrico, MD,
  • Mario Marino, MD,
  • Alessio Vona, MD,
  • Sonia Ronchey, MD, PhD,
  • Nicola Mangialardi, MD

Journal volume & issue
Vol. 5, no. 4
pp. 576 – 579

Abstract

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A 66-year-old man arrived at our emergency department 3 years after an endovascular aneurysm sealing procedure performed at another center. Computed tomography angiography showed distal migration of a Nellix endoprosthesis (Endologix, Irvine, Calif) and a posterior contained rupture. The left kidney was excluded by an occluded iliac-left renal bypass, which was performed at the time of the Nellix implantation because of unintended coverage. A t-Branch (Cook Medical, Bloomington, Ind) was implanted in an emergency, but the delivery caused disruption of the Nellix limb, requiring relining. Target vessels were bridged with VBX stents (W. L. Gore & Associates, Flagstaff, Ariz). The postoperative course was uneventful except for renal function impairment that was restored 2 weeks later. Keywords: BEVAR, Nellix, EVAS, t-Branch, Type IA endoleak