A rare case of lethal Najuta endograft collapse

Background The development of fenestrated endograft, Najuta endograft Kawasumi Laboratories, Inc, Tokyo, Japan) in thoracic endovascular aortic repair (TEVAR) has enabled the treatment of aortic arch aneurysms approaching zone 0 without the need of supra-aortic vessel branch reconstruction. However,...

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Bibliographic Details
Published in:Journal of cardiothoracic surgery 2023-11, Vol.18 (1), p.1-306, Article 306
Main Authors: Nakase, Akihiro, Inoue, Yoshito
Format: Article
Language:English
Subjects:
Aneurysm
Aneurysms
Aorta
Aortic aneurysms
Aortic arch
Aortic dissection
Blood vessels
Cardiovascular system
Care and treatment
Case Report
Cirrhosis
Complications
Coronary artery bypass
Coronary vessels
Endograft collapse
Grafting
Implants
Liver cirrhosis
Najuta
Patients
Saccule
Salvage operations
Scientific equipment and supplies industry
Stent (Surgery)
Stents
Stroke
Surgical implants
TEVAR
Thoracic aortic aneurysm
Thorax
Veins & arteries
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Summary:Background The development of fenestrated endograft, Najuta endograft Kawasumi Laboratories, Inc, Tokyo, Japan) in thoracic endovascular aortic repair (TEVAR) has enabled the treatment of aortic arch aneurysms approaching zone 0 without the need of supra-aortic vessel branch reconstruction. However, the indications of Najuta remain controversial due to complications such as endograft collapse, which is rare and lethal. Case presentation We here report a 75-year-old male patient with arch saccular aneurysm. Because of his liver cirrhosis, 2 debranching TEVAR has chosen as a treatment using Najuta. After extrathoracic bypass was performed, a CTAG stent graft was implanted distal to the LSCA in order to deliver Najuta stent graft steadily. Najuta stent graft was successfully positioned in zone 0. However, he was suffered from stent-graft collapse. After additional TEVAR to salvage stent-graft collapse to zone 0, he complicated type A dissection, which was treated by ascending aorta replacement. After salvage operation complicated multiorgan failure and he died. Keywords: Endograft collapse, Najuta, TEVAR, Thoracic aortic aneurysm
ISSN:1749-8090
1749-8090
DOI:10.1186/s13019-023-02436-6