Follow-up CT-Scan after TEVAR: is possible to prevent potential catastrophic complications?
Journal Title: Advancements in Cardiovascular Research - Year 2018, Vol 1, Issue 1
Abstract
Thoracic endovascular aortic repair (TEVAR) is considered a safe and feasible technique especially in complex cases. One of the most catastrophic complications during follow up is modular disconnection. When modular disconnection occurs, end leak is massive and risk of mortality is dramatically increased. We report our findings during follow up of a 49 years male underwent ascending aorta replacement for acute Type A aortic dissection and subsequently surgical replacement of aortic arch and TEVAR due to huge enlargement of the thoraco-abdominal false lumen. Our analysis suggest.com more attention on topographic changes of the prostheses to prevent this fatal complicationsThoracic endovascular aortic repair (TEVAR) is considered a safe and feasible technique also in complex cases with a lower morbidity and mortality rates when compared with open repair. However, follow-up CT-Scan is recommended periodically, at 6-12 months, especially when an end leak of any type has been detected. Although not frequent, modular disconnection might occur and results in one of the most catastrophic complications. In long-term follow-up studies the aneurysm sac size and native aortic morphology have been found to increase the risk for modular disconnection [1]. In the Talent Thoracic Retrospective Registry, Fattori and Co-workers reported an occurrence of modular disconnection of 1.4% [2]. In Figure 1 we found a modular disconnection in an asymptomatic 49 years old man patient during his regular follow-up CT-Scan after TEVAR. The patient underwent ascending aorta replacement for acute Type A aortic dissection five years earlier. Due to huge enlargement of the thoraces-abdominal false lumen an additional surgical treatment for the replacement of aortic arch was needed 2 years later and was achieved by means of the E-Vita Open stent-graft prosthesis Jotec Inc, Hechingen, Germany. To complete the repair, few months after aortic arch replacement, two endovascular prostheses type Relay (Bolton Medical Inc., Sunrise, FL, USA) were placed to cover the distal thoracic and abdominal aorta; stenting of superior mesenteric artery was achieved by chimney technique.
Authors and Affiliations
Saitto Guglielmo, Zeitani Jacob
Keywords
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- EP ID EP586121
- DOI 10.32474/ACR.2018.01.000104
- Views 84
- Downloads 0
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