Steinbauer, Markus G. M. and Stehr, Alexander and Pfister, Karin and Herold, Thomas and Zorger, Niels and Töpel, Ingolf and Paetzel, Christian and Kasprzak, Piotr M. (2006) Endovascular repair of proximal endograft collapse after treatment for thoracic aortic disease. Journal of vascular surgery 43 (3), pp. 609-612.
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Other URL: http://dx.doi.org/10.1016/j.jvs.2005.11.045
We report two cases of proximal endograft collapse with an almost complete aortic occlusion after endovascular tube-graft treatment of thoracic aortic disease (thoracic aneurysm after a type B dissection, traumatic blunt aortic rupture) using the TAG Gore system. Oversizing of endografts is known to cause this complication. In our two cases, however, the oversizing was between 12% and 21.7%, which is less than the allowed oversizing of 25% that is recommended by the manufacturer. This endograft-related complication might be due to a poor alignment of the currently available endografts in highly angulated and tight aortic arches. In the first case, a combined endovascular and open emergent repair procedure achieved a reopening of the proximal endograft by proximal extension (TAG Gore). In the second case, proximal extension was not considered owing to a precise positioning of the endograft distal to the left carotid artery. A balloon-expanding Palmaz stent was therefore placed interventionally in the proximal part of the TAG graft to expand the endograft and to avoid another collapse of the device. This proximal endograft collapse has to be acknowledged as a potentially hazardous complication. We therefore recommend that the proximal part of thoracic endografts in the aortic arch should be closely monitored and we offer two possible endovascular solutions for resolving the problem of proximal endograft collapse.
|Institutions:|| Medicine > Lehrstuhl für Chirurgie|
Medicine > Lehrstuhl für Röntgendiagnostik
|Subjects:||600 Technology > 610 Medical sciences Medicine|
|Refereed:||Yes, this version has been refereed|
|Created at the University of Regensburg:||Yes|
|Deposited On:||02 Mar 2007|
|Last Modified:||20 Jul 2011 20:51|