title: Stent graft perforation of a frozen elephant prosthesis: does design matter?
abstract: The frozen elephant procedure, as a hybrid method to treat aortic pathologies involving the aortic arch and the proximal descending aorta, has become an accepted treatment option. We report two late fractures of the nitinol stents of the endograft of an early frozen elephant trunk prosthesis. One patient suffered from a tear of the woven polyester fabric, causing a Type III endoleak and rapid progression of the existing descending aortic aneurysm. The patient received replacement of the descending aorta. The second patient showed a fracture of a nitinol stent without further complications during follow-up.
authors.affiliation: Clinic for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany fleissner.felix@mh-hannover.de.
authors.forename: Felix
authors.initials: F
authors.lastname: Fleissner
authors.affiliation: Clinic for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Haverich
authors.affiliation: Clinic for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
authors.forename: Malakh
authors.initials: M
authors.lastname: Shrestha
authors.affiliation: Clinic for Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Martens
mesh_terms: D000497:Alloys; D000784:Aortic Dissection / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D000072226:Computed Tomography Angiography; D057867:Endoleak / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D011474:Prosthesis Design; D011475:Prosthesis Failure; D015607:Stents / Q000009:adverse effects*
chemical_list: D000497:Alloys; C013616:nitinol
keywords: Frozen elephant trunk; Thoracic aortic surgery; Type III endoleak