T horacic aortic endovascular repair (TEVAR) has been increasingly preferred as the treatment of choice in thoracic aortic diseases (1). Endovascular treatment has been gaining popularity compared with open surgery due to its less invasive approach and rapid application, and allows the patient to easily return to daily life (2). However, TEVAR is associated with several specific complications including paraplegia, stroke, vascular injuries and local complications. These complications depend on

more »

... ascular or nonvascular comorbidities, vascular anatomy, equipment, and experience of the provider (3-6). Intravascular foreign body could be among TEVAR-related complications similar to other endovascular operations (7). Several types of equipment, including guidewire, vascular sheath, or suboptimally uncoiled stents may get stuck in the intravascular space, causing complications (8). Herein, to the best of our knowledge, we present the first report in the English literature of broken and stuck tip part of an aortic stent-graft in the intravascular space and its successful removal using the coaxial technique. Technique Case admission A 57-year-old man with 40 pack/year smoking and hypertension history was admitted to our emergency department with a sudden onset of widespread constant left pre-sternal chest pain projecting predominantly to the back. There was no history of coronary artery disease or any known aortic pathology. The patient's consciousness was open, cooperation and orientation were complete. His blood pressure was 150 mmHg systolic over 80 mmHg diastolic, and hemoglobin was 12.7 g/dL. Computed tomography (CT) revealed Stanford type-B dissecting aneurysm at the thoracic aorta extending from T4 level at the 5 mm distal to left subclavian artery through L3 level at the inferior mesenteric artery orifice at the abdominal aorta. The largest diameter of the dissecting aneurysm was 82.7 mm. All the visceral arteries were originating from the true lumen. There was also extensive angulation of the distal thoracic aorta (Fig. 1) . Left hemothorax was seen at the pleural space corresponding to a rupture (Fig. 1b) . Procedure initiation and progression Following receipt of informed consent and immediate transfer of the patient to the angiography suite, surgical right femoral cut-down and ultrasound-guided percutaneous left femoral and right brachial artery punctures were performed under general ABSTRACT Thoracic aortic endovascular repair (TEVAR) is increasingly preferred as a treatment of choice in thoracic aortic diseases. Intravascular foreign body is one of the TEVAR-related complications similar to the other endovascular operations. Here, to the our best knowledge for the first time in the English literature, this report presents an extremely rare complication of a broken and stuck tip part of aortic stent-graft in the intravascular space and successful removal by using the coaxial technique.