title: [Diagnosis and endovascular treatment of proximal endograft instability after thoracic endografting].
abstract: Four cases of proximal endostent instability after endovascular tube graft treatment of thoracic aortic disease using the TAG Gore system are reported. This potentially hazardous complication is characterized by a lack of attachment of the device to the small curvature of the aortic arch. Towering up against the hemodynamic forces in this area, the endograft could collapse and occlude the aorta. To identify this complication we recommend to perform an early postinterventional CT-scan with parasagittal reconstruction and an observation of the proximal endograft by fluorography. Endovascular solutions for the treatment of this complication may be either a proximal extension by another endograft or fixation of the proximal endograft by a balloon expandable Palmaz stent.
authors.affiliation: Gefässchirurgie und Endovaskuläre Chirurgie, Klinik und Poliklinik für Chirurgie, Universität Regensburg, Regensburg.
authors.forename: A
authors.initials: A
authors.lastname: Stehr
authors.forename: M
authors.initials: M
authors.lastname: Steinbauer
authors.forename: K
authors.initials: K
authors.lastname: Pfister
authors.forename: I
authors.initials: I
authors.lastname: Töpel
authors.forename: T
authors.initials: T
authors.lastname: Herold
authors.forename: N
authors.initials: N
authors.lastname: Zorger
authors.forename: P M
authors.initials: PM
authors.lastname: Kasprzak
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D017130:Angioplasty; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000601:surgery; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D015607:Stents; D014057:Tomography, X-Ray Computed