Diagnosis and endovascular treatment of proximal endograft instability after thoracic endografting

• Published in: Zentralblatt für Chirurgie Vol. 132; no. 3; p. 211
• Main Authors: Stehr, A, Steinbauer, M, Pfister, K, Töpel, I, Herold, T, Zorger, N, Kasprzak, P M
• Format: Journal Article
• Language: German
• Published: Germany 01.06.2007
• Subjects: Aged; Aneurysm, Dissecting - diagnostic imaging; Aneurysm, Dissecting - surgery; Angioplasty; Aorta, Thoracic - diagnostic imaging; Aorta, Thoracic - surgery; Aortic Aneurysm, Thoracic - diagnostic imaging; Aortic Aneurysm, Thoracic - surgery; Aortic Rupture - diagnostic imaging; Aortic Rupture - surgery; Blood Vessel Prosthesis; Female; Graft Occlusion, Vascular - diagnostic imaging; Graft Occlusion, Vascular - surgery; Humans; Image Processing, Computer-Assisted; Male; Postoperative Complications - diagnostic imaging; Postoperative Complications - surgery; Prosthesis Design; Prosthesis Failure; Reoperation; Stents; Tomography, X-Ray Computed
• ISSN: 0044-409X
• DOI: 10.1055/s-2007-960754

Four cases of proximal endostent instability after endovascular tube graft treatment of thoracic aortic disease using the TAG Gore system are reported. This potentially hazardous complication is characterized by a lack of attachment of the device to the small curvature of the aortic arch. Towering up against the hemodynamic forces in this area, the endograft could collapse and occlude the aorta. To identify this complication we recommend to perform an early postinterventional CT-scan with parasagittal reconstruction and an observation of the proximal endograft by fluorography. Endovascular solutions for the treatment of this complication may be either a proximal extension by another endograft or fixation of the proximal endograft by a balloon expandable Palmaz stent.