Journal of Vascular and Endovascular Therapy

Delayed Critical Stenosis in a Zenith Alpha Stent-Graft Used for the Treatment of Blunt Thoracic Aortic Injury

Introduction: Thoracic Aortic Endovascular Repair (TEVAR) is the preferred method for managing Blunt Thoracic Aortic Injuries (BTAI) but lacks robust long-term data reporting on potential delayed complications.

Case report: We present a case of a seventeen-year-old male who developed delayed critical stenosis of a Zenith Alpha stent-graft by Cook Medical which was used for treatment of a grade-2 BTAI. This was successfully managed with endovascular relining using a Zenith TX2 stent-graft.

Discussion: The complication is rare in the literature with the proposed mechanism being thrombosis secondary to infolding of the graft material as investigated by the TRANSFIX study. Endovascular re-lining of the TEVAR was successful in this patient, however, the long-term durability of the repair remains uncertain.

Conclusion: Thrombosis of TEVAR stent-grafts used for BTAI is probably a more common complication than is appreciated; especially with the Zenith Alpha device and ongoing surveillance of such patients is therefore recommended.

Author(s): Rohan Arasu1*, Ian Campbell2, and Juanita Muller3

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