Abstract:Infolding of an aortic endograft, usually characterized as endograft collapse, is a quite rare complication reported to occur mainly in thoracic aortic grafts. This report presents a case of an early proximal collapse of an endoprosthesis in an abdominal aortic aneurysm. The complication was diagnosed during the first month of follow-up and was not associated with any endoleak. It was treated with the deployment of a proximal endograft cuff with suprarenal fixation. Endograft collapse may complicate endovascul… Show more
“…On review of the literature, infolding most commonly occurs in the thoracic aorta relating to bird beaking along the distal arch of the aorta. 5 , 7 , 9 , 12 To our knowledge, only one previous case of graft infolding has been reported in the abdominal aorta, 11 and our case is the first report of infolding in a fenestrated or branch graft. Fig 3 Three-dimensional reconstruction from the 1-month postoperative computed tomography (CT) scan demonstrating the patency of the visceral vessels.…”
Section: Discussionmentioning
confidence: 53%
“…When warranted, repair of collapse or infolding can be accomplished with a variety of percutaneous or surgical methods. 7 Case reports of thoracic aorta infolding have been published with management strategies that range from balloon and stent remodeling 9 , 11 or open surgery to conservative management for asymptomatic patients. 7 , 14 In this case, balloon remodeling over the infolded area would crush the visceral stents, although protecting the stents with a kissing balloon technique may have been feasible.…”
Section: Discussionmentioning
confidence: 99%
“…Cases have been predominantly reported in thoracic endovascular cases 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ; however, to our knowledge, only one previous case has been reported in the abdominal aorta (Excluder; W. L. Gore & Associates, Flagstaff, Ariz). 11 We present a case of infolding of a fenestrated endograft (custom Cook graft) for a juxtarenal aneurysm repair. The patient has been followed up conservatively and remains asymptomatic 1 year after intervention.…”
We report a case of infolding of a fenestrated stent graft involving the visceral vessel segment after a juxtarenal abdominal aorta aneurysm repair. The patient remains free of any significant endoleak, and the aortic sac has shown regression. The patient remains asymptomatic, with no abdominal pain, with normal renal function, and without ischemic limb complications. We hypothesize that significant graft oversizing (20%-30%) with asymmetric engineering of the diameter-reducing ties may have contributed to the infolding. Because of the patient's asymptomatic nature and general medical comorbidities, further intervention was deemed inappropriate as the aneurysmal sac is regressing despite the infolding.
“…On review of the literature, infolding most commonly occurs in the thoracic aorta relating to bird beaking along the distal arch of the aorta. 5 , 7 , 9 , 12 To our knowledge, only one previous case of graft infolding has been reported in the abdominal aorta, 11 and our case is the first report of infolding in a fenestrated or branch graft. Fig 3 Three-dimensional reconstruction from the 1-month postoperative computed tomography (CT) scan demonstrating the patency of the visceral vessels.…”
Section: Discussionmentioning
confidence: 53%
“…When warranted, repair of collapse or infolding can be accomplished with a variety of percutaneous or surgical methods. 7 Case reports of thoracic aorta infolding have been published with management strategies that range from balloon and stent remodeling 9 , 11 or open surgery to conservative management for asymptomatic patients. 7 , 14 In this case, balloon remodeling over the infolded area would crush the visceral stents, although protecting the stents with a kissing balloon technique may have been feasible.…”
Section: Discussionmentioning
confidence: 99%
“…Cases have been predominantly reported in thoracic endovascular cases 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ; however, to our knowledge, only one previous case has been reported in the abdominal aorta (Excluder; W. L. Gore & Associates, Flagstaff, Ariz). 11 We present a case of infolding of a fenestrated endograft (custom Cook graft) for a juxtarenal aneurysm repair. The patient has been followed up conservatively and remains asymptomatic 1 year after intervention.…”
We report a case of infolding of a fenestrated stent graft involving the visceral vessel segment after a juxtarenal abdominal aorta aneurysm repair. The patient remains free of any significant endoleak, and the aortic sac has shown regression. The patient remains asymptomatic, with no abdominal pain, with normal renal function, and without ischemic limb complications. We hypothesize that significant graft oversizing (20%-30%) with asymmetric engineering of the diameter-reducing ties may have contributed to the infolding. Because of the patient's asymptomatic nature and general medical comorbidities, further intervention was deemed inappropriate as the aneurysmal sac is regressing despite the infolding.
“…1 Proximal collapse of an abdominal aortic stent-graft with graft thrombosis is a very rare complication following EVAR, and its management requires the use of endovascular approaches or conversion to open repair. 2,3 Endovascular aneurysm sealing (EVAS) using the Nellix system (Endologix, Irvine, CA, USA) has been proposed in the treatment of type I and type III endoleaks following EVAR, and results suggest the safety and efficacy of the procedure for this indication. 4,5 However, the use of EVAS to treat other EVAR complications has been only occasionally described.…”
To report the use of the Nellix endovascular aneurysm sealing (EVAS) system in the management of proximal stent-graft collapse associated with thrombosis following endovascular aneurysm repair (EVAR). Case Report: A 76-yearold man was admitted for proximal collapse of an aortic extension following bifurcated AFX stent-graft implantation associated with chimney grafts in both renal arteries and the superior mesenteric artery 1 month prior. Imaging identified thrombosis of the aortic stent-graft and the iliac limbs. A Nellix EVAS was placed into the AFX stent-graft to recanalize the aneurysm lumen and address the aortic thrombosis. There was no endoleak, and the renovisceral chimney stent-grafts remained patent over a follow-up of 25 months. Conclusion: While further studies are required to generalize its use, EVAS appears to be feasible in the management of aortic stent-graft collapse.
“…Aortic endograft collapse is rare and is primarily described in the thoracic aorta. Four cases of abdominal aortic endograft collapse after EVAR have been reported to date, 1 , 2 , 3 , 4 two resulting in type Ia endoleak and one resulting in graft occlusion and lower extremity ischemia. Factors predisposing to graft collapse after EVAR are unknown but likely include both anatomic and endograft-specific factors.…”
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