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Case Reports
. 2014 Apr;47(2):167-70.
doi: 10.5090/kjtcs.2014.47.2.167. Epub 2014 Apr 10.

Surgical experience of persistent type 2 endoleaks with aneurysmal sac enlargement after endovascular aneurysm repair

Seung Ho Bang  1 , Jae Bum Park  1 , Hyun Keun Chee  1 , Jun Seok Kim  1 , Il Soo Jang  2
Affiliations
Case Reports

Surgical experience of persistent type 2 endoleaks with aneurysmal sac enlargement after endovascular aneurysm repair

Seung Ho Bang et al. Korean J Thorac Cardiovasc Surg. 2014 Apr.

Abstract

Herein, we present a case of a successful treatment of persistent type 2 endoleaks associated with aneurysmal sac enlargement after endovascular aneurysm repair in an elderly patient. We confirmed the diagnosis by abdominal computed tomography and selective angiography revealing an 11.0-cm aneurysm sac with type 2 endoleaks. An attempt for the endovascular embolization of collateral arteries was unsuccessful due to anatomic variations and their multiple complex communications. Instead, transperitoneal sacotomy and direct suturing on the feeding target vessels was successfully performed without any endograft damage. In conclusion, sacotomy appears to be a feasible therapeutic substitute where endovascular or other techniques have a high risk of failure and lead to unsuccessful results.

Keywords: Complication; Endovascular stent; Prosthesis; Sacotomy.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
(A) Contrast-enhanced abdominal computed tomography (CT) at 1 month after endovascular aneurysm repair. (B) Contrast-enhanced abdominal CT shows the extravasation of the contrast material into the thrombosed abdominal aortic aneurysm sac (arrows) in the arterial phase. (C) A type 2 endoleak is not observed in the contrast-enhanced abdominal CT at 1 week after the operation.
Fig. 2
Fig. 2
An angiogram obtained with selective catheterization through the left internal iliac artery shows that the patent lumbar arteries flow into the aneurysm sac (arrow).
See this image and copyright information in PMC

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