Aortic endovascular graft failure is the malfunction or failure of an endovascular stent graft that has been implanted in the aorta, typically to treat an aortic aneurysm. This can occur due to a variety of factors such as device movement, endoleaks, structural failure, and infection.
Symptoms
The symptoms of aortic endovascular graft failure can include:
- Pain or discomfort in the abdomen or back
- Pulsating mass in the abdomen
- Fever or elevated body temperature
- Rapid heartbeat or changes in heart rate
- Weakness or fatigue
- Shortness of breath
- Loss of consciousness
It is important to note that some people with endovascular graft failure may not experience any symptoms, while others may experience severe symptoms that can be life-threatening. If you suspect that you have aortic endovascular graft failure, it is important to seek medical attention as soon as possible.
Causes
The causes of endovascular aortic graft failure can include:
Device Migration: The stent graft can move from its original position, leading to its failure.
Endoleaks: Leaks can develop around the edges of the stent graft, causing blood to bypass the graft and continue flowing through the aneurysm.
Structural Failure: The stent graft can break or collapse, leading to its failure.
Infection: An infection can develop at the site of the stent graft, causing inflammation and weakening the device.
Thrombosis: Blood clots can form inside the stent graft, obstructing blood flow and leading to its failure.
Aneurysm growth: The aneurysm can continue to grow despite the stent graft, causing it to fail.
Device corrosion: The stent graft can corrode over time, leading to its failure.
Diagnosis
Diagnosis of aortic endovascular graft infection typically involves a combination of medical history, physical examination, and imaging tests. Some common diagnostic tests for aortic endovascular graft infection include:
Blood tests: To check for signs of infection, including elevated white blood cell count or elevated levels of C-reactive protein.
Imaging tests: Such as CT scans, MRI scans, and ultrasound to visualize the stent graft and look for signs of infection or structural failure.
Angiography: This test involves injecting a contrast agent into the blood vessels and taking X-rays to visualize the flow of blood and look for signs of endoleaks, migration, or other issues.
Culture and sensitivity tests: If a local infection is suspected, a sample of the infected tissue or fluid may be taken and tested to determine the type of bacteria causing the infection and which antibiotics would be most effective.
Treatment
The treatment of aortic endovascular graft failure depends upon the specific cause and the extent of the failure. Some common treatment options include:
Endovascular revision: In some cases, the stent graft can be revised or repositioned to address the cause of the failure. This can involve placing additional stents or using endovascular devices to treat endoleaks or address other issues.If endovascular revision is not possible or effective, open surgical repair may be required. This involves making an incision in the abdomen or chest to directly access and repair the affected area.
Observation: In some cases, particularly for small or asymptomatic endoleaks, close monitoring and observation may be appropriate, with intervention only when if necessary. It is important to work closely with your doctor to determine the best treatment approach based on the specific cause and extent of the aortic endovascular graft failure, as well as individual medical history and risk factors. In some cases, multiple treatments may be required to effectively address the failure.
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