The following information was reported to gore: on (b)(6) 2022, this patient underwent an emergency endovascular treatment for an arch aortic aneurysm rupture using gore® tag® conformable thoracic stent grafts with active control system (ctag-acs).The proximal device (tgmr373720j) was deployed just distal to the left common carotid artery.When a balloon was inflated at the overlap site of the two ctag-acs, the proximal end of the device moved distally about 1 cm.A type ia endoleak was then observed.To resolve the endoleak, the left subclavian artery was plug-embolized using an amplatzer vascular plug and additional stent grafts (zenith alpha extensions 38 mm and 42 mm) were implanted into the proximal site.The type ia endoleak was resolved.During the procedure, a left carotid-axillary bypass was constructed as well.Reportedly, the bypassing procedure was not related to the migration event of the ctag-ac.It was performed because no blood flow from left vertebral artery to the left subclavian artery was confirmed.A gore® propaten® vascular graft was used for the bypass.The propaten was kinked near the anastomosis site of the carotid artery, a bare-metal stent (smart, 8 x 40 mm) was implanted in the propaten graft.The patient tolerated the procedure.No injury to the patient was reported.The reporting physician commented as follows: although the space of the aneurysmal sac was taken into consideration, the proximal end was migrated more than expected.The proximal neck seemed shorter than the pre-operative measurement.
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