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EJVES Vascular Forum
Article . 2023 . Peer-reviewed
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EJVES Vascular Forum
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Calcium in the (Big) Pipes: Intra-TEVAR Calcifications!

Authors: Salomé Kuntz; Fabien Thaveau; Michaël Ohana; Gianandrea Pasquinelli; Nabil Chakfé; Anne Lejay;

Calcium in the (Big) Pipes: Intra-TEVAR Calcifications!

Abstract

Calcification of a vascular endograft and adjacent tissues (adventitia, media, and neointima) can result in graft failure. This report shows a rare case of intraluminal calcifications in the distal end of a thoracic endovascular aortic repair (TEVAR) endograft implanted 11 years previously for grade IV blunt traumatic aortic injury (BTAI) in a young patient.A 24 year old man required TEVAR for a BTAI caused by a motorcycle accident. The procedure consisted of TEVAR and an emergency left carotid subclavian venous bypass. Eleven years after the procedure, he had severe hypertension. Intra-TEVAR calcifications appeared, gradually increasing on computed tomography angiography (CTA). Calcifications in the distal luminal end of the TEVAR were responsible for a 60% stenosis on CTA. An open approach was indicated after multidisciplinary discussion, based on the gradient value. The patient underwent explantation, with total replacement of the aortic arch and descending thoracic aorta with re-implantation of the supra-aortic vessels, under extracorporeal circulation. Macroscopic analysis showed no device degeneration but revealed a solid mass at the distal end of the TEVAR. Both microcomputed tomography and histopathology confirmed the calcific nature of the lesions.This case highlights a rare long term graft failure due to calcified neo-atherosclerosis in a TEVAR.

Keywords

Neo-atherosclerosis, Neo-atherosclerosis; TEVAR; surgical procedures, TEVAR, RD1-811, RC666-701, Diseases of the circulatory (Cardiovascular) system, Surgery, Case Report, surgical procedures

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
Average
Average
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