Total Thrombosis of Bifurcated Endoprosthesis: A Rare Complication of Endovascular Treatment of Abdominal Aortic Aneurysm

Birama Togola,Skaiste Vaitkevicienne,Olivier Szymoniak,Bréhima Bengaly,Madiassa Konaté,Drissa Traoré,Laurent Muller,Michel Peret,Mahamadou Coulibaly,Jean Louis Debrux,Nouhoum Ongoïba ,B Coulibaly

doi:10.4236/ss.2019.109037

Abstract

Background: Aortic stents are a therapeutic alternative to open surgery of abdominal aortic aneurysms. We report a case of treatment of an abdominal aortic aneurysm with a bifurcated stent, complicated by total thrombosis. Aim: The purpose of this presentation was to understand the causes, mechanisms, incidents and accidents that contributed to this complication. Case Presentation: A 48-year-old man patient with a history of high blood pressure, ischemic heart disease, chronic obstructive pulmonary disease, who was found during a surveillance check-up, an infra-renal abdominal aorta aneurysm measured at 56 mm in diameter, asymptomatic but progressive. The indication of an endovascular treatment by the placement of a bifurcated prosthesis was posed and accepted. Thrombosis of the two limbs was intra-operative, upper-end migration without endoleak at 4 months postoperative, total thrombosis of the stent at 13 months postoperatively. Explantation of the stent followed by aortobi-iliac bypass was finally performed in the 15th month. Conclusion: The cardiopulmonary antecedents, the anatomical and evolutionary characteristics of the aneurysm could have played a role in the occurrence of the complications observed in this patient.

Highlights

IntroductionFor more than two decades the aortic stents have emerged as a therapeutic alternative to open surgery in the management of abdominal aortic aneurysms
Aortic stents are a therapeutic alternative to open surgery of abdominal aortic aneurysms
We report a case of treatment of an abdominal aortic aneurysm with a bifurcated stent, complicated by total thrombosis

Summary

Introduction

For more than two decades the aortic stents have emerged as a therapeutic alternative to open surgery in the management of abdominal aortic aneurysms. Several studies have shown the benefits of endovascular treatment over conventional surgery [1]. This technological advance poses some problems in terms of complications, the monitoring of patients as well as the long-term outcome of these devices. The pharmaceutical industry has constantly improved their devices with the appearance of new generations of stents (2nd generation), reducing a number of these complications [3]. Due to these new recommendations, the number of implantations of aortic stents is increasing exponentially. The purpose of this work was to understand the causes, mechanism, incidents or accidents that contributed to this complication in order to improve the management of these patients

Case Presentation

Comments

Togola et al DOI

Conclusion