Non-Anastomotic Rupture of the Vascular Prosthesis Graft Detected Using Non-Obstructive Aortic Angioscopy: A Case Report

Fumio Yamana*, Koichi Maeda, Yukitoshi Shirakawa and Takafumi Masai

Department of Cardiovascular Surgery, Osaka Police Hospital, Japan

^*Correspondance to: Fumio Yamana 

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Abstract:

Non-anastomotic rupture of a vascular prosthesis graft in the thoracic region 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 rupture of a vascular prosthesis graft diagnosed using non-obstructive aortic angioscopy. An 85-year-old man, who had undergone total arch replacement 5 years prior presented to our institution with chest pain. Based on contrast-enhanced Computed Tomography (CT) and aortic angiography findings, we suspected extravasation of the thoracic vascular graft. Assessment of the vascular prosthesis graft in the ascending aorta using aortic angioscopy revealed a red vascular graft defect. Non-anastomotic rupture of the vascular prosthesis graft was diagnosed using aortic angioscopy. The patient underwent two debranching thoracic endovascular aortic repair (Zone 0) with right subclavian artery-left common carotid artery-left subclavian artery bypass. Completion 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. To our knowledge, this is the first report of nonanastomotic rupture of a vascular prosthesis graft detected using non-obstructive aortic angioscopy. Aortic angioscopy can help establish a definitive diagnosis in patients with disruption of the vascular prosthesis graf

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Cite the Article:

Fumio Yamana, Department of Cardiovascular Surgery, Osaka Police Hospital, Kitayama-cho 10-31, Tennouji-ku, Osaka City, Osaka 543- 0035, Japan, Tel: 810667716051; Fax: 810667752838; E-mail: [email protected].