A heli-fx guide, applier and endoanchors were used prophylactically in the endovascular treatment of the patient for an infrarenal abdominal aortic aneurysm.It was reported that the heli-fx guide and applier initially passed easily via the right femoral sheath into the proximal portion of the stent graft.3 endoanchors were placed in the ap position.It was noted that there was some difficulty in passing the heli-fx applier through the guide for placement of the third endoanchor.A fourth endoanchor was placed in the oblique position and again some difficulty was noted on passing the heli-fx applier.Another endoanchor on the left was attempted but the applier couldn't be passed through the guides distal portion.The endoanchor and sheath were removed and replaced with a stiff wired and contrast imaging showed good apposition proximally with no endoleak.It was noticed on contrast imaging that the metal ring of the end of the heli-fx guide had come free in the femoral artery.An angled guidewire was passed through the right femoral sheath, through the ring and a 12mm balloon was used to remove it.It was reported that the cause of the event is unknown.It is reported that the patient tolerated the procedure well, despite the extra time required for the procedure, which was mostly related to the aortic tortuosity and difficulty placing endograft and aptus endoanchors.No additional clinical sequelae were reported and the patient is fine.
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