Article ID Journal Published Year Pages File Type
8653367 Annals of Vascular Surgery 2018 42 Pages PDF
Abstract
Endovascular aneurysm repair has become the first-line treatment modality for infrarenal aortic aneurysms. However, obtaining successful long-term results frequently requires reinterventions. Particularly, delayed type 1a endoleaks pose a challenging problem, as they are often associated with proximal extension of the aneurysmal process to juxtarenal or pararenal aortic segments. We describe 2 remedial techniques to repair delayed type 1a endoleak by extending the seal zone to the suprarenal aorta, while incorporating the renal arteries. In the first case, a commercially available fenestrated stent graft was used. Parallel grafting technique was used in the other case. Both cases were technically successful. Follow-up imaging revealed endoleak resolution with patent renal arteries for both patients. In addition, we describe the difference between the 2 techniques, as well as relevant anatomic and device-specific considerations.
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