Traumatic Endograft Fracture With Subsequent Type IIIb Endoleak
Justin M Robbins1, Limayre B Mendoza2, Louisa L Pecchioni3
1Department of Surgery, Wright State University Boonshoft School of Medicine, Dayton, OH, USA.
The American Surgeon
|August 22, 2023
Summary
Endovascular aneurysm repair (EVAR) complications include type III endoleaks, often caused by graft damage. Blunt abdominal trauma can fracture EVAR devices, leading to type IIIb endoleaks and potential rupture.
Area of Science:
- Vascular surgery
- Medical device integrity
- Trauma management
Background:
- Endovascular aneurysm repair (EVAR) is a common treatment for abdominal aortic aneurysms (AAAs).
- Endoleaks, particularly type III, are known complications of EVAR, associated with a high risk of late rupture.
- Causes of type III endoleaks include graft distortion, component fracture, fabric wear, tears, and suture failure.
Observation:
- A case of traumatic endograft fracture following blunt abdominal trauma is presented.
- This fracture resulted in a type IIIb endoleak, a rare but serious complication.
- The event underscores the vulnerability of endografts to external forces.
Findings:
- Blunt abdominal trauma can cause mechanical failure and fracture of endovascular grafts.
- Traumatic EVAR fracture can lead to type IIIb endoleaks, necessitating urgent intervention.
- Graft integrity can be compromised by acute external forces, not just chronic wear.
Implications:
- Close evaluation of endografts after abdominal trauma is crucial.
- Prompt diagnosis and treatment of traumatic endoleaks are essential to prevent rupture.
- This case highlights the need to consider traumatic injury in the differential diagnosis of EVAR complications.
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