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[Aortic stent migration: a rare complication after endovascular repair]
K Kaouel1, M Ben Hammamia1, M Ben Mrad1
1Service de chirurgie cardiovasculaire et thoracique La Rabta, Tunis, Tunisie; Faculté de médecine de Tunis, université de Tunis, El Manar, Tunisie.
Journal Des Maladies Vasculaires
|April 9, 2014
Summary
Aortic stent migration is a rare but serious complication after endovascular aneurysm repair. This case highlights the critical need for careful patient selection and stent graft deployment to prevent potentially fatal outcomes.
Area of Science:
- Vascular Surgery
- Endovascular Interventions
- Aneurysm Repair
Background:
- Endovascular repair of abdominal aortic aneurysms (AAA) is a common procedure.
- Aorto-mono-iliac stent grafts with femoro-femoral bypass are used for AAA treatment.
- Stent migration is a known, serious complication of endovascular repair.
Observation:
- A 75-year-old man underwent endovascular AAA repair with an aorto-mono-iliac stent and femoro-femoral bypass.
- Initial angiography confirmed successful aneurysm exclusion.
- Postoperative CT scans were normal for 12 months.
Findings:
- An 18-month CT scan revealed proximal stent migration.
- This migration led to a type 1 endoleak and stent disjunction with a type 3 endoleak.
- The patient died from aneurysm rupture while awaiting revision surgery.
Implications:
- This case underscores the critical importance of precise anatomical assessment for stent graft suitability.
- Adequate stent graft deployment technique is crucial for long-term success.
- Vigilant follow-up is necessary to detect rare complications like stent migration early.
