Endovascular repair of ascending aortic rupture: Effectiveness of a fenestrated stent-graft

Keiji Uchida, Kiyotaka Imoto, Hiromasa Yanagi, Daisuke Machida, Makoto Okiyama, Shota Yasuda, Tadahisa Sugiura, Satoshi Kawaguchi, Yoshihiko Yokoi, Hiroshi Shigematsu, Munetaka Masuda

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Purpose: To present a technique for endovascular treatment using a fenestrated stent-graft in a patient with ascending aortic rupture in the setting of methicillin-resistant Staphylococcus aureus infection. Case Report: A 62-year-old woman had undergone mastectomy and radiotherapy twice for breast cancer and then coronary artery bypass grafting (CABG). She developed sternal osteomyelitis 5 years after the CABG. Sternectomy and negative-pressure wound drainage were performed, but the infection did not resolve. Ascending aortic rupture occurred 5 months after sternectomy. Endovascular therapy was considered the only effective means of achieving hemostasis. A custom-designed fenestrated stent-graft was deployed from the ascending aorta to the proximal descending aorta via a femoral artery approach without transient cardiac arrest. Bleeding completely stopped after surgery. The postoperative course was uneventful, and the inflammatory activity subsided on antibiotic therapy. At 7 months after surgery, the patient's recovery has been uneventful. Conclusion: Rupture of the ascending aorta associated with infection was successfully treated by stent-graft repair. The use of a custom-made, fenestrated stent-graft was an effective, lifesaving procedure for the management of this ascending aortic lesion.

Original languageEnglish (US)
Pages (from-to)395-398
Number of pages4
JournalJournal of Endovascular Therapy
Volume17
Issue number3
DOIs
StatePublished - Jun 2010
Externally publishedYes

Keywords

  • Aortic rupture
  • Ascending aorta
  • Fenestrated stent-graft
  • Methicillin-resistant Staphylococcus aureus
  • Sternal osteomyelitis
  • Thoracic endovascular aortic repair

ASJC Scopus subject areas

  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Uchida, K., Imoto, K., Yanagi, H., Machida, D., Okiyama, M., Yasuda, S., Sugiura, T., Kawaguchi, S., Yokoi, Y., Shigematsu, H., & Masuda, M. (2010). Endovascular repair of ascending aortic rupture: Effectiveness of a fenestrated stent-graft. Journal of Endovascular Therapy, 17(3), 395-398. https://doi.org/10.1583/10-3033.1