Stent Graft Migration Due to Structural Failure Nine Months After Thoracic Endovascular Aortic Repair Using Valiant Navion.

OBJECTIVE: This report presents a case of stent graft migration that was suspected to have occurred due to failure of the Valiant Navion device (Medtronic Inc., Santa Rosa, CA, USA). This case was rare because the broken device was removed from the living patient and examined directly.

CASE REPORT: A 69 year old man who had previously undergone thoracic endovascular aortic repair (TEVAR) with arch vessel debranching (axillo-axillary bypass with left common carotid artery bypass) for distal arch aneurysm experienced stent graft (SG) migration 9 months after the primary surgery. Total arch replacement was performed, and the migrated SG was removed. The broken stent ring and suture seams were then found. The patient was discharged on post-operative day 41 and followed up in the outpatient department.

DISCUSSION: Stent graft migration is a relatively rare complication after TEVAR and associated with type I or III endoleak, which can result in serious outcomes. In this case, it was suspected that migration had occurred after TEVAR due to structural failure of the Valiant Navion device; similar cases have been reported previously, suggesting a structural problem with the device. Therefore, other patients treated with the Navion device in the future will require careful follow up.