Article

Observations on the failure of stent-grafts in the aortic arch.

Endovascular Department, Malmö University Hospital, Malmö, Sweden.
European Journal of Vascular and Endovascular Surgery (impact factor: 2.99). 11/2007; 34(4):451-6. DOI:10.1016/j.ejvs.2007.06.005 pp.451-6
Source: PubMed

ABSTRACT The results of endovascular stent-grafts in the abdominal aorta and descending thoracic aorta have been encouraging. Expanding the use of thoracic stent-grafts in to the aortic arch has been associated with increasing numbers of complications. Recently isolated cases of stent-graft collapse have been reported.
This was a multi-centre European case series. Data was collected retrospectively on seven patients from five experienced endovascular centres with thoracic stent-graft collapse.
Of the seven patients four were treated for traumatic aortic rupture. Six were male, median age 33 (range 17-54) years. During the ensuing 2 months all patients suffered stent-graft collapse. This was symptomatic in 3 patients and the rest were identified on CT. Endovascular management was possible in 6/7 patients using either a balloon expandable stent (n=6) or further stent-graft (n=1). Two patients had persistent type I endoleak despite treatment. Two of the 7 patients died, both of which presented with symptomatic thoracic stent-graft occlusion. Both deaths were a direct result of stent-graft collapse.
Thoracic stent-graft collapse may be asymptomatic underscoring the importance of stent-graft surveillance. Endovascular management of collapse is possible in most cases using a large balloon expandable stent. Symptomatic collapse is associated with high morbidity and mortality.

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    Christian Unnewehr
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    The Journal of thoracic and cardiovascular surgery 08/2009; 139(5):1153-7. · 3.41 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

3 patients
 
7 patients
 
balloon expandable stent
 
descending thoracic aorta
 
direct result
 
endovascular centres
 
Endovascular management
 
endovascular stent-grafts
 
ensuing 2 months
 
large balloon expandable stent
 
median age 33
 
multi-centre European case series
 
seven patients
 
stent-graft collapse
 
stent-graft surveillance
 
Symptomatic collapse
 
symptomatic thoracic stent-graft occlusion
 
thoracic stent-graft collapse
 
thoracic stent-grafts
 
traumatic aortic rupture