The AneuRx stent graft: technical success versus long-term expectations in complex anatomy

AneuRx Stent-Graft Failure Four Years after TAA Exclusion

Purpose:

To present a case of graft material disruption 4 years after thoracic aortic aneurysm (TAA) exclusion with the AneuRx stent-graft.

Case Report:

In 1999, a 62-year-old man underwent successful exclusion of a descending 98-mm TAA with 2 AneuRx stent-grafts. A type I distal endoleak was diagnosed 1 month later, and a distal extension cuff was placed just proximal to the celiac trunk. One year later, a new endoleak was discovered (presumed to be type II); the patient refused proposed thrombin injection to seal the leak. The diameter of the aneurysm enlarged gradually, and in 2003, he presented with a ruptured TAA and a massive left-sided hemathorax. The patient underwent urgent open surgical repair using extracorporeal circulation; the 3 stent-grafts were removed. Unfortunately, the patient died from cardiac failure 2 days later. Macroscopic examination showed several disruptions of the graft fabric and a stent fracture, which presumably explains the endoleak and rupture.

Conclusions:

This case reaffirms the necessity of long-term stent-graft surveillance.