Late pseudocoarctation syndrome after stent-graft implantation for traumatic aortic rupture.

Abstract

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.

• Authors: Vincent Letocart, Georges Fau, Ashok Tirouvanziam, Claire Toquet, Oussama Al Habash, Patrice Guerin, Hervé Rousseau, Dominique Crochet
• Journal: Cardiovascular and interventional radiology (Cardiovasc Intervent Radiol) Vol. 36 Issue 3 Pg. 824-8 (Jun 2013) ISSN: 1432-086X [Electronic] United States
• PMID: 22810729 (Publication Type: Case Reports, Journal Article)

Topics

• Angiography
• Aortic Coarctation (etiology)
• Aortic Rupture (surgery)
• Blood Vessel Prosthesis
• Blood Vessel Prosthesis Implantation (adverse effects)
• Humans
• Stents
• Syndrome
• Young Adult