Hybrid approach for removal of an errant intra-vascular pedicle spinal fixation screw in the thoracic aorta Benjamin D. Colvard, BA, Javier E. Anaya-Ayala,

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Presentation transcript:

Hybrid approach for removal of an errant intra-vascular pedicle spinal fixation screw in the thoracic aorta Benjamin D. Colvard, BA, Javier E. Anaya-Ayala, MD, Christopher J. Smolock, MD, Alan B. Lumsden, MD, Michael J. Reardon, MD, Mark G. Davies, MD, PhD, MBA Journal of Vascular Surgery Volume 56, Issue 1, Pages 201-204 (July 2012) DOI: 10.1016/j.jvs.2011.12.084 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 Comparison of the chest X-ray from April 2007 after the spinal fixation (A) and noncontrast chest computed tomography (CT) scan; anteroposterior (B) and axial views (C), demonstrated that one of the pedicle screws from the fixation plate had migrated significantly. CT angiography three-dimensional reconstruction (D) confirmed the position of the pedicle screw on the left side, traversing the descending thoracic aorta, lying wholly within the thoracic aorta just under the anterior wall. Journal of Vascular Surgery 2012 56, 201-204DOI: (10.1016/j.jvs.2011.12.084) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 A Talent 24- × 11.5-mm endograft (Medtronic, Santa Rosa, Calif) was deployed at the level of the screw in order to exclude the aortic segment and the screw from the circulation (A). After this, an anterior aortic arteriotomy was performed via left thoracotomy and the screw was easily removed (B). Completion angiogram showed no endoleaks or extravasation (C). Journal of Vascular Surgery 2012 56, 201-204DOI: (10.1016/j.jvs.2011.12.084) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 3 A and B, Six-month follow-up computed tomography (CT) has shown no sequelae. The patient remained asymptomatic with no issues related to the surgical procedure. Journal of Vascular Surgery 2012 56, 201-204DOI: (10.1016/j.jvs.2011.12.084) Copyright © 2012 Society for Vascular Surgery Terms and Conditions