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Delayed endovascular treatment of descending aorta stent graft collapse in a patient treated for post- traumatic aortic rupture: a case report.

Nano G, Mazzaccaro D, Malacrida G, Occhiuto MT, Stegher S, Tealdi DG - J Cardiothorac Surg (2011)

Bottom Line: At 18 months the graft was still patent.Graft collapse after TEVAR is a rare event, which should be detected and treated as soon as possible.Delayed correction of this complication can be lethal due to the risk of visceral ischemia and limbs loss.

View Article: PubMed Central - HTML - PubMed

Affiliation: University of Milan, Italy.

ABSTRACT

Background: We report a case of delayed endovascular correction of graft collapse occurred after emergent Thoracic Endovascular Aortic Repair (TEVAR) for traumatic aortic isthmus rupture.

Case presentation: In 7th post-operative day after emergent TEVAR for traumatic aortic isthmus rupture (Gore TAGĀ® 28-150), a partial collapse of the endoprosthesis at the descending tract occurred, with no signs of visceral ischemia. Considering patient's clinical conditions, the graft collapse wasn't treated at that time. When general conditions allowed reintervention, the patient refused any new treatment, so he was discharged.Four months later the patient complained of severe gluteal and sural claudication, erectile disfunction and abdominal angina; endovascular correction was performed. At 18 months the graft was still patent.

Discussion and conclusion: Graft collapse after TEVAR is a rare event, which should be detected and treated as soon as possible. Delayed correction of this complication can be lethal due to the risk of visceral ischemia and limbs loss.

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CT scan before discharge. Partial collapse of the endoprosthesis at the descending tract.
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Figure 3: CT scan before discharge. Partial collapse of the endoprosthesis at the descending tract.

Mentions: On the following week signs of aortic pseudocoarctation syndrome occurred, with no popliteal and tibial pulses; femoral pulses were decreased but still palpable. A new CT scan was then performed in 7th post-operative day: no signs of graft rupture were evident but there was a partial collapse of the endoprosthesis at the descending tract, with distal slow restoration of the blood flow throughout the right lumen (Figure. 3); the patient still had pulmonary atelectasis due to hemotorax and ribs fractures.


Delayed endovascular treatment of descending aorta stent graft collapse in a patient treated for post- traumatic aortic rupture: a case report.

Nano G, Mazzaccaro D, Malacrida G, Occhiuto MT, Stegher S, Tealdi DG - J Cardiothorac Surg (2011)

CT scan before discharge. Partial collapse of the endoprosthesis at the descending tract.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3116469&req=5

Figure 3: CT scan before discharge. Partial collapse of the endoprosthesis at the descending tract.
Mentions: On the following week signs of aortic pseudocoarctation syndrome occurred, with no popliteal and tibial pulses; femoral pulses were decreased but still palpable. A new CT scan was then performed in 7th post-operative day: no signs of graft rupture were evident but there was a partial collapse of the endoprosthesis at the descending tract, with distal slow restoration of the blood flow throughout the right lumen (Figure. 3); the patient still had pulmonary atelectasis due to hemotorax and ribs fractures.

Bottom Line: At 18 months the graft was still patent.Graft collapse after TEVAR is a rare event, which should be detected and treated as soon as possible.Delayed correction of this complication can be lethal due to the risk of visceral ischemia and limbs loss.

View Article: PubMed Central - HTML - PubMed

Affiliation: University of Milan, Italy.

ABSTRACT

Background: We report a case of delayed endovascular correction of graft collapse occurred after emergent Thoracic Endovascular Aortic Repair (TEVAR) for traumatic aortic isthmus rupture.

Case presentation: In 7th post-operative day after emergent TEVAR for traumatic aortic isthmus rupture (Gore TAGĀ® 28-150), a partial collapse of the endoprosthesis at the descending tract occurred, with no signs of visceral ischemia. Considering patient's clinical conditions, the graft collapse wasn't treated at that time. When general conditions allowed reintervention, the patient refused any new treatment, so he was discharged.Four months later the patient complained of severe gluteal and sural claudication, erectile disfunction and abdominal angina; endovascular correction was performed. At 18 months the graft was still patent.

Discussion and conclusion: Graft collapse after TEVAR is a rare event, which should be detected and treated as soon as possible. Delayed correction of this complication can be lethal due to the risk of visceral ischemia and limbs loss.

Show MeSH
Related in: MedlinePlus