title: Stent strut penetration during thoracic endovascular aortic repair: report of a case.
abstract: We experienced a serious complication of proximal stent strut penetration (PSSP) during thoracic endovascular aortic repair in a 74-year-old man who underwent two-stage hybrid treatment for a distal arch thoracic aortic aneurysm. First, a debranching right common carotid-left common carotid-left subclavian artery bypass was performed. Second, a TALENT Thoracic Stent Graft (Medtronic, Tokyo, Japan) was inserted at Zone 1 (Ishimaru). At deployment, a proximal bare strut accidentally everted and penetrated the aortic wall vertically. Postoperative computed tomography revealed that one crown of the proximal strut had penetrated the aortic wall vertically and had produced an intramural hematoma around the strut. The patient was observed carefully and discharged from the hospital without any sequelae. Seven months after the procedure, there was no remarkable change and his aneurysm was well excluded. PSSP can cause retrograde type-A aortic dissections. A bare strut tends to cause proximal strut penetration more frequently than a covered strut. More caution should be taken in the deployment of a stent graft with a bare strut.
authors.affiliation: Department of Vascular Surgery, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan. masatada@aichi-med-u.ac.jp
authors.forename: Masao
authors.initials: M
authors.lastname: Tadakoshi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ishibashi
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Ishiguchi
authors.forename: Ikuo
authors.initials: I
authors.lastname: Sugimoto
authors.forename: Hirohide
authors.initials: H
authors.lastname: Iwata
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yamada
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Hida
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohta
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000293:injuries*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects*; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging*; D008297:Male; D011859:Radiography; D012075:Remission, Spontaneous; D015607:Stents / Q000009:adverse effects*; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging* / Q000209:etiology*
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