Late surgical conversion after thoracic endograft failure due to fracture of the longitudinal support wire.
OBJECTIVE
To report complications from a thoracic endograft wire fracture and early experience with elective conversion after thoracic endografting.


METHODS
A 43-year-old man underwent urgent endovascular repair of a symptomatic post-traumatic thoracic aneurysm in 1999. The patient had been involved in a car accident 14 years before. He developed clinical and radiological signs of graft infection 46 months after stent-graft implantation. Multidetector computed tomography confirmed a fracture of the longitudinal support wire in the Excluder thoracic stent-graft. Additionally, radiological signs of suspected endograft infection were described. Due to concerns over a potential chronic infection, the stent-graft was successfully excised, and a polyester graft was implanted 50 months after primary endovascular repair.


CONCLUSIONS
Recognition or strong suspicion of endograft infection requires conversion with removal of the device. Long-term follow-up after endografting is necessary to assess material fatigue that undermines the durability of these implants.
Böckler
Dittmar
D
Department of Vascular and Endovascular Surgery, Ruprecht-Karls University Heidelberg, Germany. dittmar_boeckler@med.uni-heidelberg.de
von Tengg-Kobligk
Hendrik
H
Schumacher
Hardy
H
Ockert
Stefan
S
Schwarzbach
Matthias
M
Allenberg
Jens-Rainer
JR
D000328:Adult; D000792:Angiography / Q000379:methods; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation; D002908:Chronic Disease; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000601:surgery*; D018570:Risk Assessment; D015607:Stents; D013898:Thoracic Injuries / Q000150:complications; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome