A Case of Treatment With a Combination of Covered Stents and Artificial Blood Vessel for Iliac Artery Rupture During Transcatheter Aortic Valve Replacement

TL;DR

A new treatment combining covered stents and artificial blood vessels successfully managed a rare complication during heart valve replacement surgery.

Contribution

A novel non-surgical approach using covered stents and artificial vessels is proposed for managing iliac artery rupture during TAVR.

Findings

The combination treatment achieved successful revascularization of the disrupted iliac artery.

The patient recovered well with no limb complications or major bleeding after following a restricted activity protocol.

This method offers a faster and safer alternative to surgery for managing vascular complications during TAVR.

Abstract

Vascular complications (VCs) associated with Transcatheter Aortic Valve Replacement (TAVR), particularly iliac artery rupture, pose significant challenges. We report a case of complete iliac artery disruption during TAVR. A combination of a covered stent and artificial blood vessel repair was employed to achieve revascularization of the iliac artery. In this case, the patient was placed on bed rest for 10 days to avoid stent dislodgement due to early movement and was discharged from the hospital 13 days later. After that, the patient stayed away from significant lower limb activity for 3 months after surgery and underwent enhanced follow‐up. Regular follow‐up indicated that the patient recovered well, with no significant discomfort in the right lower limb and consistent pulse in the dorsal foot artery on both sides. The treatment of such complications typically involves surgical intervention, while this method shows a new viable option for managing such VCs. By using this method, blood flow can be blocked more quickly than through surgery, which reduced the risk of massive bleeding, death, and limb loss and improved the prognosis.

Figures