Video Supplement to “TAVR Complicated by Thoracic Aortic Perforation and Intussusception of the Right Iliac: Report of Successful Emergent Management With Endovascular Techniques" [May 2019 Clinical Images article by Long and Mahoney].
An 81-year-old male at prohibitively high surgical risk with severe aortic stenosis and extensive vascular disease developed an intraprocedural iliac artery intussusception during TAVR. One hour post TAVR, the patient developed acute hypotension and respiratory distress and was found to have a left hemothorax. CT demonstrated focal perforation of the thoracic descending aorta, as well as residual tube-like cast of iliac intima residing in the distal aorta. Management using TEVAR and EVAR is demonstrated in the following video series.