Rupture of an abdominal aortic aneurysm after endovascular graft placement and aneurysm size reduction Yves S. Alimi, MD, PhD, Nabil Chakfe, MD, PhD,

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Presentation transcript:

Rupture of an abdominal aortic aneurysm after endovascular graft placement and aneurysm size reduction Yves S. Alimi, MD, PhD, Nabil Chakfe, MD, PhD, Edmond Rivoal, MD, Karah K. Slimane, Nicolas Valerio, Gunnar Riepe, MD, Jean- Georges Kretz, MD, Claude Juhan, MD Journal of Vascular Surgery Volume 28, Issue 1, Pages 178-183 (July 1998) DOI: 10.1016/S0741-5214(98)70213-7 Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Preoperative contrast-enhanced CT scan showing a 52.4-mm abdominal aortic aneurysm extending to the right common iliac artery. Journal of Vascular Surgery 1998 28, 178-183DOI: (10.1016/S0741-5214(98)70213-7) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Illustration of Stentor bifurcation with two parts: aortoiliac shaft and contralateral limb graft. Journal of Vascular Surgery 1998 28, 178-183DOI: (10.1016/S0741-5214(98)70213-7) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Contrast-enhanced CT scan performed 7 months after a bifurcated stent-graft placement, with the proximal stent covering both renal arteries. A reduction in the diameter of the aneurysm to 30.1 mm is noted. Journal of Vascular Surgery 1998 28, 178-183DOI: (10.1016/S0741-5214(98)70213-7) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Contrast-enhanced CT scan performed on an emergency basis 9 months after the stent-graft placement documented extravasation of blood out of the graft and out of the aneurysmal wall, with a left retroperitoneum hematoma. Journal of Vascular Surgery 1998 28, 178-183DOI: (10.1016/S0741-5214(98)70213-7) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Macroscopic examination of the Stentor device. A, On the proximal neck, the two first stents were displaced close together on one half of their circumference. B, The woven structure had tears at the level of 5 of the 12 knots used to attach it to the stent (arrows). C, The tears of the woven structure on the entire length of the longitudinal seam of the limb allowed visualization of the stents from the outside (arrows). Journal of Vascular Surgery 1998 28, 178-183DOI: (10.1016/S0741-5214(98)70213-7) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Endoscopic view of the Stentor prosthesis. A, Ruptured ligations between the two stents of the body. B, Tears of the woven structure at the level of the longitudinal seam of the limb. Journal of Vascular Surgery 1998 28, 178-183DOI: (10.1016/S0741-5214(98)70213-7) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 7 Macroscopic view of the left limb tube. A, The knot passed through the woven structure and was visible from outside of the graft (arrow). The textile structure is well organized and not damaged. B, Knots passed through the woven structure are also visible from the outside (small arrows). Note the holes related to major dislocations of the woven structure (large arrows). Journal of Vascular Surgery 1998 28, 178-183DOI: (10.1016/S0741-5214(98)70213-7) Copyright © 1998 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions