Endograft collapse after thoracic endovascular aortic repair

Area of Science:

• Vascular Surgery
• Cardiovascular Research
• Medical Device Technology

Background:

• Endograft collapse is a rare but serious complication following thoracic endovascular aortic repair (TEVAR).
• Understanding the factors contributing to this complication is crucial for improving patient management and outcomes.

Purpose of the Study:

• To elucidate the causes, timing, and optimal management strategies for endograft collapse post-TEVAR.
• To analyze the existing literature on endograft collapse to identify trends and risk factors.

Main Methods:

• A systematic review and meta-analysis of published case reports on endograft collapse after TEVAR.
• Inclusion of 32 articles detailing 60 patient cases, with data extraction and systematic database entry.

Main Results:

• Endograft collapse most frequently followed TEVAR for traumatic thoracic aortic injuries (65%) and type B aortic dissections (15%).
• Median time to diagnosis was 15 days, with excessive oversizing (26.7%) and aortic arch curvature (48%) as primary causes.
• 30-day mortality was 8.3%, with 3-year freedom from death higher in asymptomatic patients (83.1%) versus symptomatic (72.7%).

Conclusions:

• Endograft collapse typically manifests early post-TEVAR, especially after traumatic injury repair.
• Increased clinical suspicion within the first month and advancements in endovascular device design are essential for improved long-term outcomes.