Nakano R, Iwakoshi S, Shimizu S, Nakai T, Ichihashi S, Tanaka T. Jaw claudication and branch perfusion reduction as rare complications of
fenestrated thoracic endovascular aortic repair.
J Vasc Surg Cases Innov Tech 2024;
10:101484. [PMID:
38633579 PMCID:
PMC11022092 DOI:
10.1016/j.jvscit.2024.101484]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 03/04/2024] [Indexed: 04/19/2024] Open
Abstract
We report a rare case of jaw claudication following fenestrated thoracic endovascular aortic repair for a saccular aortic arch aneurysm. The brachiocephalic artery (BCA) was preserved with fenestration and intentionally half covered. Although discharged without any complications 2 weeks after the procedure, the patient subsequently experienced right mandibular fatigue at mealtime and hypotension in the right upper extremity. Angiography revealed a flap-like structure in the BCA orifice, with a 100-mm Hg pressure gradient between the aorta and BCA. Intravascular ultrasound revealed a stenosed BCA with a cord-like structure, which was considered a graft protrusion. Bare metal stenting was performed, which promptly resolved the symptoms.
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