Re-TEVAR in treatment of stent graft-induced new entry between two non-overlapping stent-grafts: a case report
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CASE REPORT
Open Access
Re-TEVAR in treatment of stent graftinduced new entry between two nonoverlapping stent-grafts: a case report Yiwei He1,2, Shoujun Tang2, Yongheng Zhang2, Jianping Liu2 and Haining Zhou1,2*
Abstract Background: Progress of the aortic disease after the stent graft treatment of aortic dissection implicates the potential risks of stent graft-induced new entry (SINE). Although rarely reported, it should be vigilant in patients who might incur serious complication in early period after the thoracic endovascular aortic repair (TEVAR). Thus, the development of aortic disease-specific stent grafts would assist in achieving positive patient outcomes when suffering SINE. However, it is an extremely rare for SINE between two non-overlapping stent-grafts. Case presentation: We here reported a 59-year-old male patient with sudden onset of chest pain for 4 h. Multi-detector computed tomography (MDCT) revealed a huge SINE formed between two non-overlapping stent-grafts. The re-TEVAR surgery was performed and the patient experienced a good recovery. Conclusion: The SINE between two non-overlapping stent-grafts treated by re-TEVAR operation was alternative and feasible. The short-term and medium-term follow-up results were satisfactory. Keywords: Stent graft-induced new entry, Thoracic endovascular aortic repair, Type B aortic dissection
Introduction Thoracic endovascular aortic repair (TEVAR) was first reported in 1999 and its first-generation equipment was applied to endovascular treatment of thoracic aortic aneurysm, and subsequently widely applied to Stanford B aortic dissection (TBAD) [1]. Stent graft-Induced New Entry (SINE) appears to be an uncommon iatrogenic phenomenon typically occurring as a late complication of the endovascular treatment of aortic dissections, specifically in TBAD. This complication was defined as a new tear caused by the stent graft, excluding natural disease progression or iatrogenic injury, which can lead to high mortality rates. To our knowledge, it is an extremely rare case for SINE between two non-overlapping stent-grafts. In this case report, the patient with SINE * Correspondence: [email protected] 1 Zunyi Medical University, Zunyi 653000, China 2 Department of Cardiothoracic Surgery, Suining Central Hospital, No. 127, Desheng Road, Chuanshan District, Suining 629000, China
between two non-overlapping stent-grafts were successfully treated by a re-TEVAR operation.
Case presentation A 59-year-old male patient was admitted to our hospital with sudden onset of chest pain for 4 h. The patient had a longstanding history of controlled hypertension. Three years ago, the patient presented himself to a local hospital with sudden onset of chest and abdominal pain. Multi-detector computed tomography (MDCT) revealed aortic arch dissection combined with distal dissection of descending aorta (Fig. 1a1, a2), of the case who had undergone the primary TEVAR assisted by Chimney technique with two non-overlapping stentgrafts surgery at that time. The proximal breaks were covered w
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