Case ReportSuccessful endovascular management of endoleak-like phenomenon following open abdominal aortic aneurysm repair

- Endoleaks after open abdominal aortic aneurysm (AAA) repair are a rare.
- Type I endoleak-like phenomenon post-open AAA is also defined as a proximal pseudoaneurysm.
- Type I endoleak-like phenomenon may result in aneurysmal sac rupture into the peritoneal cavity.
- This is the first reported case in the literature of successful management of concomitant types I and potential type II endoleaks post-open AAA repair using an endovascular approach.

IntroductionEndoleaks are a well-known complication after endovascular aortic repair. Type I endoleak-like phenomenon (also defined as a proximal pseudoaneurysm) post-open abdominal aortic aneurysm (AAA) repair is described as an anastomotic leak causing recurrent pressurization of the original aneurysm sac. It is rare but may result in aneurysmal sac rupture into the peritoneal cavity.ReportA 78-year-old man presented with a progressively enlarged aneurysmal sac due to proximal anastomotic degeneration of the proximal suture line associated with an outflow through a patent large lumbar vessel following a previous emergency open AAA repair. This was successfully treated using a combination coils and ethylene-vinyl alcohol copolymer. An Endoluminal tube stent graft was successfully deployed to seal the aortic anastomotic dehiscence.ConclusionEndovascular treatment of an anastomotic dehiscence associated with a large outflow lumbar artery post-open AAA repair is feasible and safe.