Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8653377 | Annals of Vascular Surgery | 2018 | 18 Pages |
Abstract
We report the case of a 75-year-old man submitted to traditional endovascular aortic repair (EVAR) for infrarenal abdominal aortic aneurysm. He presented a late type II endoleak 6Â months after operation, initially without sac enlargement. One year later, a computed tomography scan control demonstrated a sac expansion >10Â mm, also responsible for a secondary proximal type I endoleak. The patient was submitted to transarterial embolization of lumbar arteries through left internal iliac artery, followed by type I endoleak correction with a proximal cuff deployment. Intraoperative angiography revealed no signs of endoleak. Six months later, a sudden enlargement of the sac was detected, with evidence of type III endoleak, probably consequence of the lumbar arteries embolization, promptly corrected through an aortoaortic endograft. In conclusion, even if a conservative approach for type II endoleak without sac enlargement is proposed, sometimes a sudden sac enlargement could be responsible for catastrophic events in the absence of strict follow-up. The sac embolization during EVAR could reduce the incidence of type II endoleak during follow-up, with reoperation and hospital cost reduction.
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Authors
Mafalda Massara, Stefano Notarstefano, Giovanni De Caridi, Raffaele Serra, Pasquale Gerardi, Roberto Prunella, Giovanni Impedovo,