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CASE REPORTS  BEST OF LAPAROSCOPY, ENDOSCOPY AND MINIMALLY INVASIVE SURGERY


Minerva Chirurgica 2009 August;64(4):431-36

language: English

Early endograft collapse following endovascular treatment of a traumatic thoracic aortic disruption: a case report

Megalopoulos A. 1, Soulountsi V. 2, Vasiliadis K. 3, Trellopoulos G. 1, Bitzani M. 3

1 1st Surgical Department, General Regional Hospital “George Papanikolaou” Thessaloniki, Greece
2 Intensive Care Unit, General Regional Hospital “George Papanikolaou” Thessaloniki, Greece
3 Surgical Department, General Hospital of Kilkis, Kilkis, Greece


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The authors present the case of a 39-year-old man who underwent endovascular repair of a thoracic aortic disruption. Implantation of a Gore TAG stent-graft achieved total exclusion of the traumatic lesion with no contrast extravasation. However, on the third postoperative day, the patient developed complete anuria necessitating continuous venovenous hemofiltration. On the IV postoperative day there were no palpable femoral pulses and the pressure gradient between the lower and upper limbs was -80 mmHg. Given the development of severe intestinal and peripheral hypoperfusion status a possible endograft collapse was suspected. Urgent computed tomography (CT) angiography demonstrated central subtotal collapse of the device and proper distal sealing. A second TAG stent-graft was deployed successfully within the collapsed device with no contrast extravasation and good apposition of the stent-graft to the aortic wall. At 6 months, there is no sign of graft collapse or endoleak. Endovascular reintervention succeeded re-expansion of the collapsed endoprosthesis and resolution of the initial symptoms.

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