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      A Case of Aortic Strain due to Spring Back Force by Stent Graft 3 Years after Thoracic Endovascular Aortic Repair

      case-report

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          Abstract

          A 79-year-old man underwent 1-debranched thoracic endovascular aortic repair (TEVAR) for a saccular aneurysm of the distal arch of the aorta. Computed tomography performed 3 years after surgery revealed a significant displacement of the distal side of the stent graft and severe deformity due to displacement of the aorta. There were no obvious findings after aortic dissection. Endovascular treatment was selected, and surgery was performed semiemergency. Additional TEVAR was performed to restore the aortic shape and displacement to its normal position.

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          Stent graft-induced new entry after endovascular repair for Stanford type B aortic dissection.

          ZHIHUI DONG, Daqiao Guo, Yuqi Wang … (2010)
          Stent graft-induced new entry (SINE), defined as the new tear caused by the stent graft and excluding those arising from natural disease progression or iatrogenic injury from the endovascular manipulation, has been increasingly observed after thoracic endovascular aortic repair (TEVAR) for Stanford type B dissection in our center. SINE appears to be remarkably life threatening. We investigated the incidence, mortality, causes, and preventions of SINE after TEVAR for Stanford type B dissection. Data for 22 patients with SINE were retrospectively collected and analyzed from 650 patients undergoing TEVAR for type B dissection from August 2000 to June 2008. An additional patient was referred to our center 14 months after TEVAR was performed in another hospital. The potential associations of SINE with Marfan syndrome, location of SINE and endograft placement, and the oversizing rate were analyzed by Fisher exact probability test or t test. We found 24 SINE tears in 23 patients, including SINE at the proximal end of the endograft in 15, at the distal end in 7, and at both ends in 1. Six patients died. SINE incidence and mortality reached 3.4% and 26.1%, respectively. Two SINE patients were diagnosed with Marfan syndrome, whereas there were only 6 Marfan patients among the 651 patients. The 16 proximal SINEs were evidenced at the greater curve of the arch and caused retrograde type A dissection. The eight distal SINEs occurred at the dissected flap, and five caused enlarging aneurysm whereas three remained stable. The endograft was placed across the distal aortic arch during the primary TEVAR in all 23 patients. The incidence of SINE was 33.33% among Marfan patients vs 3.26% among non-Marfan patients (P = .016). There was no significant difference in mortality between proximal and distal SINE (25% vs 28.6%, P > .99), incidence of SINE between endograft placement across the arch and at the straight portion of descending thoracic aorta (23 of 613 vs 0 of 38, P = .39), and the oversizing rate between SINE and non-SINE patients (13% ± 4.5% vs 16% ± 6.5%, P = .98). SINE appears not to be rare after TEVAR for type B dissection and is associated with substantial mortality. The stress yielded by the endograft seems to play a predominant role in its occurrence. It is important to take this stress-induced injury into account during both design and placement of the endograft. Copyright © 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
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            Risk factors for distal stent graft-induced new entry tear after endovascular repair of thoracic aortic dissection

            Ludovic Canaud, Thomas Gandet, Julien Sfeir … (2019)
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              Stent Graft-Induced New Entry Tear (SINE) – Intentional and NOT

              G Hughes (2019)
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                Author and article information

                Journal
                Journal ID (nlm-ta): Ann Vasc Dis
                Journal ID (iso-abbrev): Ann Vasc Dis
                Title: Annals of Vascular Diseases
                Publisher: Japanese College of Angiology / The Japanese Society for Vascular Surgery / Japanese Society of Phlebology (Italian Cultural Institute Building 8F, Kudan-Minami 2-1-30, Chiyoda-ku, Tokyo 102-0074, Japan )
                ISSN (Print): 1881-641X
                ISSN (Electronic): 1881-6428
                Publication date (Electronic): 23 February 2024
                Publication date (Print): 25 June 2024
                Volume: 17
                Issue: 2
                Pages: 171-174
                Affiliations
                [1 ]Department of Cardiovascular Surgery, Akashi Medical Center, Akashi, Hyogo, Japan
                [2 ]Department of Diagnostic and Interventional Radiology, Kobe University Hospital, Kobe, Hyogo, Japan
                Author notes
                [*] [* ]Corresponding author: Kuntae Ahn, MD. Department of Cardiovascular Surgery, Akashi Medical Center, 743-33 Yagi, Ohkubo-cho, Akashi, Hyogo 674-0063, Japan Tel: +81789361101, Fax: +81789367456 E-mail: arken724@ 123456aol.com
                Article
                DOI: 10.3400/avd.cr.23-00081
                PMC ID: 11196173
                PubMed ID: 38919318
                SO-VID: ea99d7b9-e828-4b4a-866f-b639b5450093
                Copyright © @ 2024 The Editorial Committee of Annals of Vascular Diseases.
                License:

                This article is distributed under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided the credit of the original work, a link to the license, and indication of any change are properly given, and the original work is not used for commercial purposes. Remixed or transformed contributions must be distributed under the same license as the original.

                History
                Date received : 18 September 2023
                Date accepted : 24 January 2024
                Categories
                Subject: Case Report

                Keywords: tevar,complications after tevar,spring back force,distal sine
                Data availability:
                Keywords: tevar, complications after tevar, spring back force, distal sine

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