Late Aortic Arch Perforation by Graft-Anchoring Stent: Complication of Endovascular Thoracic Aneurysm Exclusion
- 1 August 1998
- journal article
- case report
- Published by International Society of Endovascular Specialists in Journal of Endovascular Surgery
- Vol. 5 (3) , 274-277
- https://doi.org/10.1583/1074-6218(1998)005<0274:laapbg>2.0.co;2
Abstract
To describe a fatal case of late aortic perforation by an endograft-anchoring stent. A 69-year-old woman presented 2 years after thoracoabdominal aneurysm repair with a 9-cm dilatation of the descending thoracic aorta proximal to the conventional aortic graft. A 38-mm Dacron graft with multiple Gianturco Z-stents sutured inside was placed transluminally across the aortic arch such that part of the uncovered portion of the proximal stent was partially across the left subclavian orifice. Four months later, the patient died from massive hemorrhage. Autopsy showed that the uncovered portion of the proximal stent had perforated the aortic arch. This case stresses the need for low-profile stent-grafts and smaller, more flexible introducer systems. Anchoring stents must be flexible, less traumatic, and strong enough to create a watertight seal even in tortuous vessels. To avoid aortic arch damage by thoracic stent-grafts, the proximal stent should be fully covered by the fabric.Keywords
This publication has 7 references indexed in Scilit:
- Three-Year Experience With the White-Yu Endovascular GAD Graft for Transluminal Repair of Aortic and Iliac AneurysmsJournal of Endovascular Surgery, 1997
- Tracheal Wire Stent Complications in Malacia: Implications of Position and DesignThe Annals of Thoracic Surgery, 1997
- Endovascular stent–graft repair of thoracic aortic aneurysmsThe Journal of Thoracic and Cardiovascular Surgery, 1996
- Treatment of Malignant Esophageal Obstructions with Covered Metallic Z Stents: Long-term Results in 52 PatientsJournal of Vascular and Interventional Radiology, 1995
- Delayed rupture of aortic aneurysms following endovascular stent graftingThe American Journal of Surgery, 1995
- Endovascular repair of abdominal aortic aneurysms and other arterial lesionsJournal of Vascular Surgery, 1995
- Infrarenal aortic aneurysm structure: Implications for transfemoral repairJournal of Vascular Surgery, 1994