Malpositioned or Dislocated Aortic Endoprostheses: Repositioning Using Percutaneous Pull-Down Maneuvers

l l Purpose: To present the capabilities and potential complications of 2 percutaneous tech-niques for repositioning malpositioned or dislodged aortic endografts. Methods: Seven male patients (median age 67.9 years, range 59 to 78) required correction of misplaced or dislocated endografts in the thoracic (n 5 1) or infrarenal abdominal aorta (n 5 6). In 1 patient, an infrarenal bifurcated stent-graft was mistakenly deployed across a renal artery; repositioning was accomplished by tugging caudally on a guidewire placed across the endograft bifurcation and exteriorized from both femoral arteries. An inflated balloon catheter was used to reposition 3 dislocated aortic devices (1 thoracic, 2 infrarenal) and 3 iliac graft limbs that had disconnected from the main graft body 6 to 12 months after implantation. Results: Repositioning maneuvers were successful in all cases, with the devices being moved from 5 to 27 mm (median 7.8 mm). There were no procedure-related complications. Conclusions: Nonsurgical repositioning of misplaced aortic prostheses is technically fea-sible in individual cases. The risk associated with the procedure, however, cannot yet be evaluated. J Endovasc Ther 2000;7:123–131 Key words: endovascular grafts, Vanguard, Talent, Corvita, Excluder, renal arteries, sub