Document Detail


Endograft collapse after endovascular treatment for thoracic aortic disease.
MedLine Citation:
PMID:  20049595     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Endovascular treatment is an established therapy for thoracic aortic disease. Collapse of the endograft is a potentially fatal complication. We reviewed 16 patients with a thoracic endograft between 2001 and 2006. Medical records of the treated patients were studied. Data collected include age, gender, diagnosis, indication for endoluminal treatment, type of endograft, and time of follow up. All patients (n = 16; mean age, 61 years; range, 21-82 years) underwent computed tomography (CT) for location of the lesion and planning of the intervention. Time of follow-up with CT scan ranged from 1 to 61 months. Indications for endovascular treatment were degenerative aneurysm (n = 7; 44%), aortic dissection (n = 2; 12%), perforated aortic ulcer (n = 4; 25%), and traumatic aortic injury (n = 3; 19%). Three patients suffered from a collapse of the endograft (one patient distal, two patients proximal) between 3 and 8 days after endovascular treatment. These patients were younger (mean age, 37 +/- 25 years vs. 67 +/- 16 years; P < 0.05) and showed more oversizing (proximal, 36 +/- 19.8% vs. 29 +/- 20.7% [P > 0.05]; distal, 45 +/- 23.5% vs. 38 +/- 21.7% [P > 0.05]). Proximal collapse was corrected by placing a bare stent. In conclusion, risk factors for stent-graft collapse are a small lumen of the aorta and a small radius of the aortic arch curvature (young patients), as well as oversizing, which is an important risk factor and is described for different types of endografts and protheses (Gore TAG and Cook Zenith). Dilatation of the collapsed stent-graft is not sufficient. Following therapy implantation of a second stent or surgery is necessary in patients with a proximal endograft collapse. Distal endograft collapse can possibly be treated conservatively under close follow-up.
Authors:
Dirk Bandorski; Martin Brück; Hans-Ulrich Günther; Christoph Manke
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Publication Detail:
Type:  Journal Article     Date:  2010-01-05
Journal Detail:
Title:  Cardiovascular and interventional radiology     Volume:  33     ISSN:  1432-086X     ISO Abbreviation:  Cardiovasc Intervent Radiol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-12     Completed Date:  2010-08-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003538     Medline TA:  Cardiovasc Intervent Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  492-7     Citation Subset:  IM    
Affiliation:
Klinikum Wetzlar, Medizinische Klinik 1, Forsthausstr 1, 35578 Wetzlar, Germany. dirk.bandorski@t-online.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angiography
Aorta, Thoracic* / injuries,  pathology
Aortic Diseases / radiography,  surgery*
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / methods*
Female
Humans
Male
Middle Aged
Postoperative Complications / surgery*
Prosthesis Failure*
Radiography, Interventional
Retrospective Studies
Risk Factors
Statistics, Nonparametric
Stents
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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