Thoracic aortic endograft collapse after endovascular treatment of a traumatic pseudoaneurysm

Aortic endograft placement is evolving into the standard of care for treatment of patients with anatomically suitable thoracic aortic aneurysms. Application of this technique and these devices in other thoracic aortic pathology, such as traumatic pseudoaneurysms, symptomatic type B aortic dissections, penetrating ulcers, and even mycotic aneurysms, appears to be promising. We report a case in which a stent graft was used to treat a post-traumatic pseudoaneurysm of the thoracic aorta. The case was complicated by delayed collapse of the endograft, which led to hypoperfusion of the extremities, kidneys, and intestines. Reestablishment of endograft patency and distal reperfusion was achieved by placement of two balloon-expandable stents within the endograft. Potential factors leading to the development of this complication are discussed.