Endovascular salvage of iliac valve dislodgement during transfemoral TAVR using the endo-jail technique: a case report

Abstract

Valve dislodgement during transcatheter aortic valve replacement is rare and usually involves migration into the left ventricle or aorta. We report a 90-year-old man with symptomatic severe aortic stenosis who underwent elective transfemoral TAVR complicated by valve dislodgement into the external iliac artery after expandable sheath failure in a tortuous, focally diseased iliac segment. After unsuccessful retrieval attempts, a covered stent was deployed to jail the valve frame against the arterial wall, restoring flow and permitting completion of TAVR during the same procedure. This case highlights a rare iliac complication requiring rapid endovascular bailout when retrieval fails.