In vivo crushing of an aortic stent enables endovascular repair of a largeinfrarenal aortic pseudoaneurysm

Purpose: To report an unusual approach to endovascular exclusion of a large aortic pseudoaneurysm. Methods and Results: A 63-year-old male had an unsuccessful endovascular re pair of an aortic anastomotic pseudoaneurysm that left an expanded, uncover ed Palmaz stent lying obliquely within the aorta. After nearly 3 years, the pseudoaneurysm enlarged to 7 cm, and the patient became symptomatic. Repai r of the pseudoaneurysm was accomplished by crushing the indwelling stent t o allow placement of a stent-graft. Conclusions: Malpositioned stents that are hindering an endoluminal procedu re may be crushed against the arterial wall in vivo to facilitate passage o f endovascular instruments or devices.