A Bailout of Iliac Perforation Using a Viabahn Endoprosthesis during Transfemoral Aortic Valve Implantation

Abstract

Objective: Here, we report the strategy of bailout in case of transfemoral-transcatheter aortic valve implantation (TF-TAVI)-induced iliac arterial injury during TAVI.

Case Presentation: We show a case of a 79-year-old male who presented with severe symptomatic aortic stenosis. We performed TAVI from the left common femoral artery. We inserted a 14-Fr e-sheath without difficulty, and we delivered and deployed successfully a 26-mm SAPIEN3-valve (Edwards Lifesciences, Irvine, CA, USA). When the 14-Fr e-sheath was removed, the aortography showed massive extravasation from the left iliac artery. As a result, we were able to rapidly treat the iliac perforation using Viabahn endoprostheses and less invasively than a conventional stent-graft or surgical repair while obtaining good patency with the Viabahn endoprostheses.

Conclusion: We had an experience that the use of Viabahn endoprostheses is safe and effective in case of TF-TAVI-induced iliac arterial injury during TAVI, with good short- and mid-term outcomes.