Department of Vascular and Endovascular Surgery, 34379Royal Hobart Hospital, Hobart, TAS, Australia.
Vascular. 2023 Apr;31(2):266-269. doi: 10.1177/17085381211062737. Epub 2021 Dec 29.
The Zenith endovascular graft (Cook Medical, Bloomington, IN, USA) is a well-recognised device used in endovascular repair of abdominal aortic aneurysms (EVAR). After a small number of reported cases of suprarenal stent separation from the main body of the graft, modifications were made to the strength and durability of the suture line attachment of the proximal bare metal component prior to release in 2003. This report describes a further case of suprarenal stent separation and type IA endoleak in a patient who underwent an EVAR using the Zenith device in 2012.
We present a case report of a 77-year-old male with incidental finding of type IA endoleak on a background of elective endovascular repair for 50.4-mm infrarenal abdominal aortic aneurysm (AAA), with a Cook Zenith endograft. Computed tomography (CT) demonstrated separation of the suprarenal bare metal stent from the main body of the endograft, with resultant graft migration and increase in native aneurysm sac size.
The patient underwent semi-urgent surgery with successful placement of a bridging thoracic stent graft between the lowest renal artery and main body of the pre-existing graft.
This case report describes a rare complication of Zenith devices, additionally emphasising the importance of regular surveillance imaging following EVAR.
Zenith 血管内移植物（美国库克医疗公司，布卢明顿，IN）是一种广泛应用于腹主动脉瘤血管内修复（EVAR）的器械。在少数报道的肾上支架与移植物主体分离的病例之后，2003 年在 Zenith 移植物近端裸金属部件的缝线连接的强度和耐久性方面进行了改进。本报告描述了 2012 年使用 Zenith 装置行 EVAR 的患者出现肾上支架分离和 1A 型内漏的进一步病例。
我们报告了 1 例 77 岁男性患者的病例，该患者因 50.4mm 下肾腹主动脉瘤（AAA）择期行血管内修复，偶然发现 1A 型内漏，使用 Cook Zenith 移植物。CT 显示肾上裸金属支架与移植物主体分离，导致移植物迁移和原生动脉瘤囊增大。
患者行半紧急手术，在预先存在的移植物主体和最低肾动脉之间成功放置了一个桥接胸主动脉支架移植物。
本病例报告描述了 Zenith 器械的一种罕见并发症，进一步强调了 EVAR 后定期进行影像学监测的重要性。
