Efficacy of non-obstructive aortic angioscopy for detecting a thoracic aortic graft rupture: a case report
Abstract Background Non-anastomotic thoracic aortic graft rupture is extremely rare and difficult to diagnose. Non-obstructive general angioscopy can help monitor the aortic intima and detect the locations of abnormal findings, while aortic angioscopy can detect vulnerable plaques in the aorta, whic...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-03-01
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| Series: | Surgical Case Reports |
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| Online Access: | https://doi.org/10.1186/s40792-022-01394-w |
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| author | Fumio Yamana Koichi Maeda Yuma Hamanaka Noriko Kodani Keitaro Domae Masatoshi Hata Yoshiharu Higuchi Yukitoshi Shirakawa Takafumi Masai |
| author_facet | Fumio Yamana Koichi Maeda Yuma Hamanaka Noriko Kodani Keitaro Domae Masatoshi Hata Yoshiharu Higuchi Yukitoshi Shirakawa Takafumi Masai |
| author_sort | Fumio Yamana |
| collection | DOAJ |
| description | Abstract Background Non-anastomotic thoracic aortic graft rupture is extremely rare and difficult to diagnose. Non-obstructive general angioscopy can help monitor the aortic intima and detect the locations of abnormal findings, while aortic angioscopy can detect vulnerable plaques in the aorta, which are difficult to visualize using conventional diagnostic methods. Herein, we report the case of a patient with non-anastomotic thoracic aortic graft rupture diagnosed using non-obstructive aortic angioscopy. Case presentation An 85-year-old man who had undergone total arch replacement 5 years prior complained of chest pain. Emergent contrast-enhanced computed tomography (CT) revealed an intra-mediastinal hematoma around the vascular graft of the ascending aorta and angiography revealed pooling of contrast medium on the dorsal side of the vascular graft. We suspected extravasation of the thoracic vascular graft. Aortic angioscopic examination revealed a red vascular graft defect that matched extravasation at the contralateral level of the prosthetic left common carotid artery branch. Subsequently, non-anastomotic thoracic aortic graft rupture was diagnosed. The patient underwent a two-debranching thoracic endovascular aortic repair (Zone 0) with a right subclavian artery-left common carotid artery-left subclavian artery bypass. Postoperative angiography revealed disappearance of the extravasation from the graft rupture site, patent grafted vessels with flow, and no endoleak. Follow-up CT at 6 months postoperatively showed no extravasation. Conclusions To our knowledge, this is the first report of non-anastomotic thoracic aortic graft rupture detected using non-obstructive aortic angioscopy. Aortic angioscopy can help establish a definitive diagnosis in patients with aortic graft rupture. |
| first_indexed | 2024-12-13T09:06:49Z |
| format | Article |
| id | doaj.art-4ac11eabd01748b489cc2cdb6f6cc837 |
| institution | Directory Open Access Journal |
| issn | 2198-7793 |
| language | English |
| last_indexed | 2024-12-13T09:06:49Z |
| publishDate | 2022-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj.art-4ac11eabd01748b489cc2cdb6f6cc8372022-12-21T23:53:02ZengSpringerOpenSurgical Case Reports2198-77932022-03-01811410.1186/s40792-022-01394-wEfficacy of non-obstructive aortic angioscopy for detecting a thoracic aortic graft rupture: a case reportFumio Yamana0Koichi Maeda1Yuma Hamanaka2Noriko Kodani3Keitaro Domae4Masatoshi Hata5Yoshiharu Higuchi6Yukitoshi Shirakawa7Takafumi Masai8Department of Cardiovascular Surgery, Osaka Police HospitalDepartment of Cardiovascular Surgery, Osaka University Graduate School of MedicineDepartment of Cardiology, Osaka Police HospitalDepartment of Cardiovascular Surgery, Osaka Police HospitalDepartment of Cardiovascular Surgery, Osaka Police HospitalDepartment of Cardiovascular Surgery, Osaka Police HospitalDepartment of Cardiology, Osaka Police HospitalDepartment of Cardiovascular Surgery, Osaka General Medical CenterDepartment of Cardiovascular Surgery, Osaka Police HospitalAbstract Background Non-anastomotic thoracic aortic graft rupture is extremely rare and difficult to diagnose. Non-obstructive general angioscopy can help monitor the aortic intima and detect the locations of abnormal findings, while aortic angioscopy can detect vulnerable plaques in the aorta, which are difficult to visualize using conventional diagnostic methods. Herein, we report the case of a patient with non-anastomotic thoracic aortic graft rupture diagnosed using non-obstructive aortic angioscopy. Case presentation An 85-year-old man who had undergone total arch replacement 5 years prior complained of chest pain. Emergent contrast-enhanced computed tomography (CT) revealed an intra-mediastinal hematoma around the vascular graft of the ascending aorta and angiography revealed pooling of contrast medium on the dorsal side of the vascular graft. We suspected extravasation of the thoracic vascular graft. Aortic angioscopic examination revealed a red vascular graft defect that matched extravasation at the contralateral level of the prosthetic left common carotid artery branch. Subsequently, non-anastomotic thoracic aortic graft rupture was diagnosed. The patient underwent a two-debranching thoracic endovascular aortic repair (Zone 0) with a right subclavian artery-left common carotid artery-left subclavian artery bypass. Postoperative angiography revealed disappearance of the extravasation from the graft rupture site, patent grafted vessels with flow, and no endoleak. Follow-up CT at 6 months postoperatively showed no extravasation. Conclusions To our knowledge, this is the first report of non-anastomotic thoracic aortic graft rupture detected using non-obstructive aortic angioscopy. Aortic angioscopy can help establish a definitive diagnosis in patients with aortic graft rupture.https://doi.org/10.1186/s40792-022-01394-wAortic angioscopyVascular prosthesis graftNon-anastomotic ruptureContrast-enhanced computed tomography |
| spellingShingle | Fumio Yamana Koichi Maeda Yuma Hamanaka Noriko Kodani Keitaro Domae Masatoshi Hata Yoshiharu Higuchi Yukitoshi Shirakawa Takafumi Masai Efficacy of non-obstructive aortic angioscopy for detecting a thoracic aortic graft rupture: a case report Surgical Case Reports Aortic angioscopy Vascular prosthesis graft Non-anastomotic rupture Contrast-enhanced computed tomography |
| title | Efficacy of non-obstructive aortic angioscopy for detecting a thoracic aortic graft rupture: a case report |
| title_full | Efficacy of non-obstructive aortic angioscopy for detecting a thoracic aortic graft rupture: a case report |
| title_fullStr | Efficacy of non-obstructive aortic angioscopy for detecting a thoracic aortic graft rupture: a case report |
| title_full_unstemmed | Efficacy of non-obstructive aortic angioscopy for detecting a thoracic aortic graft rupture: a case report |
| title_short | Efficacy of non-obstructive aortic angioscopy for detecting a thoracic aortic graft rupture: a case report |
| title_sort | efficacy of non obstructive aortic angioscopy for detecting a thoracic aortic graft rupture a case report |
| topic | Aortic angioscopy Vascular prosthesis graft Non-anastomotic rupture Contrast-enhanced computed tomography |
| url | https://doi.org/10.1186/s40792-022-01394-w |
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