Transfemoral Stent-Graft Placement to Treat a Complication of the Frozen Elephant Trunk Procedure

Purpose:To report a novel complication of a hybrid “frozen elephant trunk” endograft used in the treatment of a multisegmentally diseased aorta.Case Report:A 53-year-old man with chronic type A aortic dissection and previous replacement of the supracoronary ascending aorta underwent a “frozen elephant trunk” procedure using a hybrid endograft. The stent-graft was placed deep in the descending aorta to cover the multiple distal re-entries. Due to ineffective covering of the re-entries, a patent false lumen led to rapid repressurization of the false lumen immediately distal to the circumferential elephant trunk anastomosis. Compression of the non-stented portion of the hybrid endograft caused a functional aortic stenosis, with severe hemodynamic consequences. Endovascular treatment of the compression by retrograde transfemoral placement of a stent-graft in the non-stented portion of the hybrid endograft achieved free flow in the distal aorta.Conclusion:This case documents a new complication of the frozen el...