Balloon-Expandable Stent Complications During Endovascular Grafting

Abstract

Intraluminal stented grafts are currently the focus of much attention and research. Increasing use of balloon-expandable stents in these devices has resulted in a spectrum of deployment associated complications and new technical challenges for surgeons. The various techniques used to overcome problems during intravascular stented graft deployment are reported. Deployment complications occurred in 3 of 19 adult hound dogs subjected to endovascular stented graft placement. The stented grafts consisted of a balloon expandable stent sewn to a 6-cm-long,10.mm-diameter, thin-walled polytetrafluoroethylene graft. Reengaging a nondeployed stented graft that slid off an expansion balloon, managing a partially deployed stented graft with inability to disengage a broken angioplasty balloon, and repositioning a free stent within the aorta are described. Treatment of stented graft complications was associated with no morbidity or mortality and minimal blood loss and added only fifteen to thirty minutes of procedure time. All situations were managed successfully without the need for an open retrieval procedure. Deployment complications associated with intravascular stented grafts may be successfully managed with endovascular techniques using the existing graft delivery system and additional small-diameter balloon catheters.