AneuRx stent-graft failure four years after TAA exclusion.
OBJECTIVE
To present a case of graft material disruption 4 years after thoracic aortic aneurysm (TAA) exclusion with the AneuRx stent-graft.


METHODS
In 1999, a 62-year-old man underwent successful exclusion of a descending 98-mm TAA with 2 AneuRx stent-grafts. A type I distal endoleak was diagnosed 1 month later, and a distal extension cuff was placed just proximal to the celiac trunk. One year later, a new endoleak was discovered (presumed to be type II); the patient refused proposed thrombin injection to seal the leak. The diameter of the aneurysm enlarged gradually, and in 2003, he presented with a ruptured TAA and a massive left-sided hemathorax. The patient underwent urgent open surgical repair using extracorporeal circulation; the 3 stent-grafts were removed. Unfortunately, the patient died from cardiac failure 2 days later. Macroscopic examination showed several disruptions of the graft fabric and a stent fracture, which presumably explains the endoleak and rupture.


CONCLUSIONS
This case reaffirms the necessity of long-term stent-graft surveillance.
Schepens
Marc A
MA
Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands. m.schepens@antonius.net
van den Berg
Jos C
JC
Moll
Frans L
FL
Dossche
Karl M
KM
Heijmen
Robin H
RH
D017542:Aneurysm, Ruptured / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D015607:Stents