Late Surgical Conversion after Thoracic Endograft Failure Due to Fracture of the Longitudinal Support Wire

• Published in: Journal of endovascular therapy 2005-02, Vol.12 (1), p.98-102
• Main Authors: Böckler, Dittmar, von Tengg-Kobligk, Hendrik, Schumacher, Hardy, Ockert, Stefan, Schwarzbach, Matthias, Allenberg, Jens-Rainer
• Format: Article
• Language: English
• Subjects: Adult; Angiography - methods; Aortic Aneurysm, Thoracic - diagnostic imaging; Aortic Aneurysm, Thoracic - etiology; Aortic Aneurysm, Thoracic - therapy; Blood Vessel Prosthesis Implantation; Chronic Disease; Follow-Up Studies; Humans; Male; Prosthesis Failure; Prosthesis-Related Infections - diagnostic imaging; Prosthesis-Related Infections - surgery; Risk Assessment; Stents; Thoracic Injuries - complications; Time Factors; Tomography, X-Ray Computed; Treatment Outcome
• ISSN: 1526-6028; 1545-1550
• DOI: 10.1583/04-1328.1

Purpose: To report complications from a thoracic endograft wire fracture and early experience with elective conversion after thoracic endografting. Case Report: A 43-year-old man underwent urgent endovascular repair of a symptomatic post-traumatic thoracic aneurysm in 1999. The patient had been involved in a car accident 14 years before. He developed clinical and radiological signs of graft infection 46 months after stent-graft implantation. Multidetector computed tomography confirmed a fracture of the longitudinal support wire in the Excluder thoracic stent-graft. Additionally, radiological signs of suspected endograft infection were described. Due to concerns over a potential chronic infection, the stent-graft was successfully excised, and a polyester graft was implanted 50 months after primary endovascular repair. Conclusions: Recognition or strong suspicion of endograft infection requires conversion with removal of the device. Long-term follow-up after endografting is necessary to assess material fatigue that undermines the durability of these implants.