Late pseudocoarctation syndrome after stent-graft implantation for traumatic aortic rupture.
The present observation illustrates an unusual complication occurring after stent-grafting (S-graft) for aortic isthmus rupture. A 22-year-old patient, treated by S-graft in the emergency department for traumatic aortic rupture, was readmitted 10 months later with pseudocoarctation syndrome. A membrane was found inside the stent-graft that had induced a pseudo-dissection, which caused the pseudocoarctation syndrome. Surgical treatment consisted of removing the stent-graft and membrane and replacing it with a vascular implant. The patient's clinical course was fair. The suggested mechanism was circumferential neoendothelialization of the stent-graft. Dehiscence caused the superior part of the membrane to drop into the lumen of the stent-graft creating a "false channel" that compressed the "true lumen" and induced "pseudocoarctation" syndrome. The cause of the extensive neointimalization remains unexplained. Thoracic aortic stent-grafts require regular follow-up monitoring by angioscan or angio-magnetic resonance imaging.
Institut du Thorax, University Hospital of Nantes, Nantes, France. vincent.letocart@chu-nantes.fr
Vincent
V
Letocart
Georges
G
Fau
Ashok
A
Tirouvanziam
Claire
C
Toquet
Oussama
O
Al Habash
Patrice
P
Guerin
Hervé
H
Rousseau
Dominique
D
Crochet
D000792:Angiography; D001017:Aortic Coarctation / Q000209:etiology*; D001019:Aortic Rupture / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D015607:Stents; D013577:Syndrome; D055815:Young Adult