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Computed tomography scans and operative findings. (a) and (b) Computed tomography scan on admission to our hospital: the proximal side of the stent graft (arrow) is dislocated and floating inside the aneurysm. (c) Operative findings: a Dacron graft was anastomosed to the proximal aorta and to the stent graft distally. To suture the device, the proximal flare was removed and the margin was reinforced with a strip of Teflon felt (arrows). (d) Computed tomography shows an increase in size to 94 mm 2 years after the operation with a faint onion skin pattern enhancement (asterisk).
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On admission to our hospital, computed tomography (CT) scanning showed that the proximal end of the stent graft was dislocated inside the descending aortic aneurysm, which had enlarged to a diameter of 80 mm, suggesting impending rupture (Figure 1(a) and (b)).
Computed tomography scans obtained before and after initial TEVAR. (a) and (b) Preoperative scans (sagittal and coronal planes) demonstrate the proximal neck of the aneurysm. (c) and (d) Follow-up scans obtained after TEVAR. There is no endoleak. The proximal landing of the stent graft shows no problems at this time.
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We subsequently obtained these CT scans performed before and after initial TEVAR (Figure 2).