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Trauma-Induced Thoracic Stent Graft Migration and Dissecting Aneurysm Rupture
Naoto Jingami1, Tomoyuki Yunoki1, Junichi Tazaki2
1Department of Primary Care and Emergency Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Annals of Thoracic Surgery Short Reports
|January 10, 2025
Summary
Blunt trauma can cause graft migration and aortic rupture years after thoracic endovascular aortic repair (TEVAR). This case highlights the risk of late complications following TEVAR, even after minor injuries.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Trauma Surgery
Background:
- Thoracic endovascular aortic repair (TEVAR) is a common procedure for aortic dissections.
- Chronic type B aortic dissection carries risks of long-term complications.
- Previous TEVAR interventions aim to stabilize aortic pathology.
Observation:
- An 82-year-old male with a history of TEVAR experienced sudden dyspnea and hemoptysis after a fall.
- Computed tomography revealed significant graft migration, endoleak, and dissecting aneurysm rupture.
- The patient sustained blunt trunkal trauma from falling off a stationary bicycle.
Findings:
- Trauma-induced blunt injury can precipitate graft migration and aortic rupture in patients with prior TEVAR.
- Endovascular graft failure and aortic dissection can occur years after the initial repair.
- Prompt re-intervention with emergent TEVAR was successful in managing the acute complication.
Implications:
- Physicians should consider the risk of late graft migration and aortic rupture after TEVAR, especially in trauma patients.
- Long-term surveillance may be necessary for patients who have undergone TEVAR.
- Blunt trunkal trauma represents a potential trigger for catastrophic aortic events in this population.
