Surgical conversion for intragraft thrombosis following endovascular repair of traumatic aortic injury

Marone, Enrico Maria; Kahlberg, Andrea; Tshomba, Yamume; Logaldo, Davide; Chiesa, Roberto

doi:10.1016/j.jvs.2011.07.075

Cited by 16 publications

(13 citation statements)

References 13 publications

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“…In-situ thrombosis of thoracic aortic endovascular stent grafts has been described, and has been postulated to be related to infolding or collapse of the endograft [3,4]. Asymptomatic non-occlusive mural thrombus has also been reported within endovascular stent grafts following repair of traumatic aortic disruption [5].…”

Section: Discussionmentioning

confidence: 99%

Thrombosis of a descending thoracic aortic endovascular stent graft in a patient with factor V Leiden: case report

Kumpati

Patel

Bull

2014

J Cardiothorac Surg

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We present a case of a 14 year old Caucasian male who underwent initially successful endovascular repair of a traumatic injury to the descending thoracic aorta. The patient had undiagnosed Factor V Leiden at the time of the endovascular repair. He later presented with thrombosis of the endovascular stent graft, necessitating open removal of the stent graft and replacement of the involved aorta with a Dacron graft.

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Section: Discussionmentioning

confidence: 99%

Thrombosis of a descending thoracic aortic endovascular stent graft in a patient with factor V Leiden: case report

Kumpati

Patel

Bull

2014

J Cardiothorac Surg

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“…Furthermore, follow-up and screening has been difficult in the young trauma population. Review of the literature reported 10 prior cases of late TEVAR thrombosis ( Table 1 ) [ 4 , 6 , 8 – 15 ].…”

Section: Discussionmentioning

confidence: 99%

Late Stent Thrombosis in a Patient with Endovascular Aortic Repair for Blunt Thoracic Aortic Injury

Chiu

Kaitoukov

Ordons

2022

Case Reports in Vascular Medicine

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Blunt thoracic aortic injury (BTAI) is associated with high mortality and morbidity. Thoracic endovascular aortic repair has become the recommended treatment modality given improved short-term results compared to open repair. We present a case of a 19-year-old male who presented with acute paralysis and multiorgan dysfunction from acute TEVAR thrombosis. Systemic thrombolysis, catheter-directed thrombolysis followed by aspiration thrombectomy, and angioplasty were initially successful in restoring perfusion. However, he developed progressive multiorgan failure related to prompt reocclusion within 48 hours. This case is the first to describe thrombolysis and angioplasty as a management strategy for acute TEVAR thrombosis. We also review the literature surrounding this uncommon complication.

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“…In reviewing the literature, nine case reports of acute thrombotic (near) occlusion of a thoracic stentgraft were found ( Table 1 ). 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

Intragraft Obstructive Thrombus Two Years After Endovascular Repair of Traumatic Aortic Injury: A Case Report and Review of the Literature

Beijer

Scholtes

Truijers

et al. 2021

EJVES Vascular Forum

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Introduction Thoracic endovascular aortic repair (TEVAR) is the treatment of choice for blunt thoracic aortic injury (BTAI) and has proven to be a good alternative to open surgery. TEVAR requires less operation time, has fewer complications, can be used for relatively unstable patients, and is associated with a significantly lower mortality rate. Moreover, long term follow up data demonstrate low re-intervention rates and stentgraft failure. Report The case of a 21 year old man who sustained severe trauma, including a traumatic pseudoaneurysm of the descending thoracic aorta distal to the left subclavian artery in 2016, is presented. The patient was treated by TEVAR. Two years later, he presented with progressive paraplegia due to stentgraft occlusion occurring four days after a new high velocity motor vehicle accident. An axillofemoral bypass was performed to assure blood flow to the lower body. Two days later the stentgraft was removed via left thoracotomy and replaced by a Dacron graft. Gross examination showed severe thrombus formation at the proximal edge, and a thrombotic occlusion in the middle and distal third of the stent. After three months of hospitalisation the patient was discharged to a rehabilitation clinic with partial recovery of his paraplegia. As of June 2020, the patient was able to walk without assistance and his paraplegia improved with only loss of sensation of his lower legs. Conclusion A serious thrombotic complication two years after TEVAR is described. Although TEVAR is the currently preferred treatment for BTAI, more research is needed to examine the mechanisms behind this thrombotic complication and to elucidate whether TEVAR is definitive treatment or a “bridge to further surgery”. Smaller diameter stentgrafts, anticoagulation, regular (lifelong) follow up imaging, and prophylactic surgical conversion in (selected) patients might help to prevent this serious complication.

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Surgical conversion for intragraft thrombosis following endovascular repair of traumatic aortic injury

Cited by 16 publications

References 13 publications

Thrombosis of a descending thoracic aortic endovascular stent graft in a patient with factor V Leiden: case report

Thrombosis of a descending thoracic aortic endovascular stent graft in a patient with factor V Leiden: case report

Late Stent Thrombosis in a Patient with Endovascular Aortic Repair for Blunt Thoracic Aortic Injury

Intragraft Obstructive Thrombus Two Years After Endovascular Repair of Traumatic Aortic Injury: A Case Report and Review of the Literature

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