Early stent fracture and collapse of a Zenith TX2 thoracic stent graft used for traumatic aortic rupture

Structural failure and collapse of thoracic stent grafts may cause fatal complications that are easily overlooked on follow-up imaging. A young man with multiple injuries from a motorcycle crash was treated with endografting for an aortic transection. The clinical course was initially satisfactory but deteriorated one week after the injury and the patient died two weeks later. Autopsy and retrospective assessment of chest X-rays revealed early fractures and collapse of the stent graft that had been overlooked and may have contributed to the lethal outcome. The design of thoracic stent grafts needs to be improved for treatment of traumatic aortic transection. Careful follow-up of these patients is warranted.