Advanced

Late aortic arch perforation by graft-anchoring stent: complication of endovascular thoracic aneurysm exclusion

Malina, Martin LU ; Brunkwall, Jan; Ivancev, Krassi LU ; Lindblad, Bengt LU ; Malina, Janne; Nyman, Ulf LU and Risberg, Bo (1998) In Journal of Endovascular Surgery 5(3). p.274-277
Abstract
PURPOSE: To describe a fatal case of late aortic perforation by an endograft-anchoring stent. METHODS AND RESULTS: 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. CONCLUSIONS: This case stresses the need for low-profile stent-grafts... (More)
PURPOSE: To describe a fatal case of late aortic perforation by an endograft-anchoring stent. METHODS AND RESULTS: 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. CONCLUSIONS: 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. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
endovascular grafting, complication, Gianturco stent, stent-graft, thoracic aorta
in
Journal of Endovascular Surgery
volume
5
issue
3
pages
274 - 277
publisher
International Society of Endovascular Specialists
external identifiers
  • pmid:9761584
  • scopus:0031780440
ISSN
1074-6218
DOI
10.1583/1074-6218(1998)005<0274:LAAPBG>2.0.CO;2
language
English
LU publication?
yes
id
5009fafd-af49-409c-8fc8-22de8a97725d (old id 1112763)
date added to LUP
2008-07-11 10:40:23
date last changed
2017-01-01 07:02:40
@article{5009fafd-af49-409c-8fc8-22de8a97725d,
  abstract     = {PURPOSE: To describe a fatal case of late aortic perforation by an endograft-anchoring stent. METHODS AND RESULTS: 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. CONCLUSIONS: 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.},
  author       = {Malina, Martin and Brunkwall, Jan and Ivancev, Krassi and Lindblad, Bengt and Malina, Janne and Nyman, Ulf and Risberg, Bo},
  issn         = {1074-6218},
  keyword      = {endovascular grafting,complication,Gianturco stent,stent-graft,thoracic aorta},
  language     = {eng},
  number       = {3},
  pages        = {274--277},
  publisher    = {International Society of Endovascular Specialists},
  series       = {Journal of Endovascular Surgery},
  title        = {Late aortic arch perforation by graft-anchoring stent: complication of endovascular thoracic aneurysm exclusion},
  url          = {http://dx.doi.org/10.1583/1074-6218(1998)005<0274:LAAPBG>2.0.CO;2},
  volume       = {5},
  year         = {1998},
}