Attempt type I endoleak repair

May 22, 2017

Question:

"PT presents to undergo repair of type I endoleak. Bilateral femoral access with left subclavian cutdown was performed to accommodate large french sheath. From subclavian access with great effort 12 french catheter advanced into descending aorta. Noticed was significant bleeding at the left subclavian cutdown site. Conduit separated from the artery tearing the artery. Covered stent from right femoral approach encountered difficulty advancing across arterial tear due to kinked wire. Stent was pulled back, however unable to remove from right femoral decision was made to deploy in external iliac. Once again through the wire access of the subclavian a stent was successfully deployed across the area of arterial damage in the mid left subclavian. A complete thoracic & abdominal aortogram was performed confirming large type I endoleak. Decision to reexplore alternative treatment option for type I endoleak." Code selection 36200 left subclavian, 36215 right femoral, 36140 left femoral approach, and 37236 stent placement of arterial tear. Recommendations?

Question ID: 9296
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