Nano Giovanni, Mazzaccaro Daniela, Malacrida Giovanni, Occhiuto Maria Teresa, Stegher Silvia, Tealdi Domenico G
University of Milan, Italy.
J Cardiothorac Surg. 2011 May 24;6:76. doi: 10.1186/1749-8090-6-76.
We report a case of delayed endovascular correction of graft collapse occurred after emergent Thoracic Endovascular Aortic Repair (TEVAR) for traumatic aortic isthmus rupture.
In 7th post-operative day after emergent TEVAR for traumatic aortic isthmus rupture (Gore TAG® 28-150), a partial collapse of the endoprosthesis at the descending tract occurred, with no signs of visceral ischemia. Considering patient's clinical conditions, the graft collapse wasn't treated at that time. When general conditions allowed reintervention, the patient refused any new treatment, so he was discharged.Four months later the patient complained of severe gluteal and sural claudication, erectile disfunction and abdominal angina; endovascular correction was performed. At 18 months the graft was still patent.
Graft collapse after TEVAR is a rare event, which should be detected and treated as soon as possible. Delayed correction of this complication can be lethal due to the risk of visceral ischemia and limbs loss.
我们报告一例创伤性主动脉峡部破裂急诊胸主动脉腔内修复术（TEVAR）后移植物塌陷延迟血管腔内矫正的病例。
在因创伤性主动脉峡部破裂行急诊TEVAR（戈尔TAG® 28-150）术后第7天，降主动脉段的内支架部分塌陷，无内脏缺血迹象。考虑到患者的临床情况，当时未对移植物塌陷进行治疗。当一般情况允许再次干预时，患者拒绝任何新的治疗，因此出院。四个月后，患者出现严重的臀部和小腿间歇性跛行、勃起功能障碍和腹部绞痛；遂进行了血管腔内矫正。18个月时移植物仍保持通畅。
TEVAR后移植物塌陷是一种罕见事件，应尽早发现并治疗。由于存在内脏缺血和肢体丧失的风险，这种并发症的延迟矫正可能是致命的。
