We encountered a challenging case of endovascular repair for distal stent graft-induced new entry (SINE) using the AFX aortic cuff. Postoperative computed tomography revealed no endoleak with a preferable conformation change of the externally mounted graft material of the AFX cuff against the tear.

We encountered a challenging case of endovascular repair for distal stent graft-induced new entry (SINE) using the AFX aortic cuff. Distal SINE was detected on follow-up computed tomography in a 68-year-old man who previously underwent primary thoracic endovascular aortic repair for Stanford type B chronic aortic dissection. The AFX aortic cuff was deployed via a previous endograft to just above the super mesenteric artery with blockage of the celiac artery origin. Postoperative computed tomography revealed no endoleak with a preferable conformation change of the externally mounted graft material of the AFX cuff against the tear (active-seal fixation).

Background & Aim: Traumatic aortic injury (TAI) is a life-threatening condition. We present cases of 7 patients with TAI limited at the isthmus. Case description: Seven patients with TAI were treated between January 2015 and December 2018; TAI was caused by motor vehicle crashes in all cases. The patient characteristics and the post-operation data were collected and analyzed. We performed thoracic endovascular aortic repair (TEVAR) for five patients during their first hospitalization using Relay Plus® (Japan Lifeline, Japan). While patient 6 underwent TEVAR 5 years after the injury, patient 7 was recommended conservative care because she had dementia. Since most of these patients did not have a history of hypertension, they were not on antihypertensive medications after TEVAR. Conclusions: In cases of TAI, intervention by TEVAR in the acute phase improves the patient’s quality of life. Additionally, TEVAR is expected to prevent TAI from enlarging to form an aortic aneurysm.