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Valentina Galuppo, Domenico Gruosso, Giuliana Maldonado, Hug Cuellar, Arturo Evangelista, Late thrombosis of thoracic aortic stent graft, European Heart Journal - Cardiovascular Imaging, Volume 16, Issue 1, January 2015, Page 111, https://doi.org/10.1093/ehjci/jeu164
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Extract
A 17-year-old motorcycle accident victim underwent urgent successful thoracic endovascular aortic repair (TEVAR) of blunt thoracic aortic rupture. On computed tomography (CT), the rupture was distal to the origin of the subclavian artery and was treated with a custom-made, 24 mm, 6.6 cm TX2 stent. The stent graft was inserted via the femoral artery and positioned at the level of the area of aortic rupture.
One year later, the patient was admitted to the emergency department for sudden onset of severe dyspnoea, abdominal pain, and paraparesis of the legs.
Transoesophageal echocardiography revealed severe circumferential thrombosis of the distal part of the stent (Panels A and B, and see Supplementary data online, Movie S1) producing significant stenosis.
Thoracoabdominal CT showed in-stent thrombosis causing severe stenosis of the distal descending thoracic aorta, without signs of stent degeneration, endoleaks, and/or collapse of the scaffold (Panel C).
Emergency open aortic bypass surgery was performed with an extra-anatomical Dacron graft connecting the ascending aorta to the supracoeliac abdominal aorta, as seen on the postoperative CT (Panel D). The patient was discharged with no additional complications.
