Delayed Intimal Blowout after Endovascular Repair of Aortic Dissection

The authors have seen four cases of asymptomatic delayed intimal injury adjacent to a stent graft diagnosed 7 to 16 months after thoracic endovascular aortic repair. Endovascular repeat intervention was successfully performed in three of the four cases as described in the present report. A second consecutive “intimal blowout” in one patient remains under close radiologic surveillance. Possible causes for the intimal blowouts, including stent-graft size, landing zone anatomy, and intrinsically weak aortic tissue, are discussed.