Hybrid Open and Endovascular Treatment of an Erosion of Elephant Trunk Prosthesis in a Patient with Endoleak

Background: Perforation of the elephant trunk limb is rare but represents a challenging situation in patients who have undergone open repair for aortic dissection. We aim to present a case of an endoleak between the elephant trunk and the thoracic endoprosthesis with an increased diameter of a concomitant AAA.

Case: The patient underwent:

▪ Emergency endovascular treatment of the AAA with a suprarenal fixation bifurcated aortic graft with a mild endoleak type Ia due to proximal endograft infolding.

▪ Total debranching of the supra-aortic vessels and TEVAR via antegrade access from an accessory branch to fix the endoleak at the aortic arch.

▪ During the same procedure, through right femoral access, a stent was deployed just below the lower renal artery to re-expand the aortic device. CT scan follow-up confirmed the good results of both the procedures.

Discussion: Perforation of the elephant trunk limb is rare. The hybrid approach to this life-threatening situation might represent a safe and effective alternative to open surgery.

Publication History

Article published online:
09 February 2023