A Case of Hydrophilic Polymer Embolism after TEVAR

Masaharu Hatakeyama＊	Ryo Taguchi＊	Kazuo Ito＊
Kozo Fukui＊

（Department of Cardiovascular Surgery, Aomori City Hospital＊, Aomori, Japan）

Hydrophilic polymer embolism（HPE）associated with endovascular therapy has steadily gained attention. We report a case of a 70-year-old man who had undergone one-debranched TEVAR. He had a history of distal arch replacement for dissecting aortic aneurysm 14 years earlier. Pseudoaneurysm at the proximal site of graft anastomosis was found on computed tomography（CT）angiogram during the follow-up. 1 debranching TEVAR was performed using the pull-through technique. Fourth days after the procedure, a skin rash appeared in the right lower extremity around the access site. Skin biopsy with pathological examination revealed HPE. We decided to observe a patient because there was no symptom of limb ischemia. Skin lesions improved and he was discharged on the 27th postoperative day. Hydrophilic polymers are widely used in the endovascular devices and there is an urgent need to better understand the complication of HPE.

 

Jpn. J. Cardiovasc. Surg. 48:428-432（2019）

Keywords：TEVAR;hydrophilic polymer embolism（HPE）;polyvinylpyrrolidone（PVP）;endovascular treatment