Endovascular Aortic Repair Complications and the Power of Endovascular Solutions
| Autor: | Giovanni Impedovo, Pasquale Gerardi, Giovanni De Caridi, Stefano Notarstefano, Raffaele Serra, Roberto Prunella, Mafalda Massara |
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| Rok vydání: | 2018 |
| Předmět: |
ANEURYSM REPAIR
II ENDOLEAK OUTCOMES RUPTURE Male medicine.medical_specialty Endoleak Computed Tomography Angiography medicine.medical_treatment 030204 cardiovascular system & hematology 030230 surgery Aortic repair Aortography Blood Vessel Prosthesis Implantation 03 medical and health sciences Aortic aneurysm 0302 clinical medicine medicine.artery medicine Humans Embolization Ultrasonography Doppler Color Aged Computed tomography angiography medicine.diagnostic_test business.industry Endovascular Procedures General Medicine medicine.disease Embolization Therapeutic Abdominal aortic aneurysm Surgery Treatment Outcome Cuff Cardiology and Cardiovascular Medicine business Lumbar arteries Aortic Aneurysm Abdominal Abdominal surgery |
| Zdroj: | Annals of Vascular Surgery. 49:311.e15-311.e18 |
| ISSN: | 0890-5096 |
| DOI: | 10.1016/j.avsg.2017.11.046 |
| Popis: | 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 6 months after operation, initially without sac enlargement. One year later, a computed tomography scan control demonstrated a sac expansion >10 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. |
| Databáze: | OpenAIRE |
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