Abstract
Endograft occlusion is a critical complication that can occur following the placement of an endovascular stent-graft to treat aortic aneurysms or other vascular pathologies. The occlusion of the endograft can result from various factors, including thrombosis, embolization, or the development of graft-related complications. Understanding the mechanisms and risk factors associated with endograft occlusion is essential for optimizing patient outcomes and devising effective prevention and management strategies.
Thrombosis of the endograft may arise due to altered blood flow patterns, pre-existing coagulation disorders, or inadequate anticoagulation therapy. Embolization, on the other hand, can occur when debris or thrombi detach from the aortic wall or the endograft itself, leading to distal obstruction and ischemia.
The assessment of endograft occlusion often involves imaging modalities such as computed tomography angiography (CTA) or duplex ultrasonography. Early detection of occlusive events is crucial to initiate prompt intervention and minimize potential morbidity and mortality. Therapeutic options for endograft occlusion may include endovascular techniques like catheter-directed thrombolysis, mechanical thrombectomy, or angioplasty with stent placement. In some cases, open surgical conversion or graft explantation may be necessary.
Ultimately, the management of endograft occlusion requires a multidisciplinary approach involving interventional radiologists, vascular surgeons, and other healthcare specialists to deliver timely and comprehensive care. Ongoing research and clinical experience in this field will continue to refine treatment strategies, enhance outcomes, and improve the long-term durability of endovascular stent-grafts for aortic and vascular pathologies.
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Mariani, M. et al. (2024). Endograft Occlusion. In: Geroulakos, G., Avgerinos, E., Becquemin, J.P., Makris, G.C., Froio, A. (eds) Mastering Endovascular Techniques. Springer, Cham. https://doi.org/10.1007/978-3-031-42735-0_64
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