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. 2021 Dec 25;14(4):393-395.
doi: 10.3400/avd.cr.21-00092.

A Case of Late Type Ia Endoleak After Endovascular Aneurysm Sealing Using the Nellix System: Proximal Extension with Triple Chimney and Gutter Endoleak Embolization

Pietro Volpe  1 , Antonino Alberti  1 , Vittorio Alberti  1 , Mafalda Massara  1
Affiliations

A Case of Late Type Ia Endoleak After Endovascular Aneurysm Sealing Using the Nellix System: Proximal Extension with Triple Chimney and Gutter Endoleak Embolization

Pietro Volpe et al. Ann Vasc Dis. .

Abstract

An 87-year-old man, who submitted to endovascular aneurysm sealing (EVAS) on 2017, presented a type Ia endoleak 2 years later, with enlargement of the aneurysmal sac. We planned an endovascular procedure of correction consisting of a proximal extension through two covered stent grafts deployed into the previous Nellix stent grafts, with associated triple chimney. However, 3 months later, he had a further 5 mm aneurysmal sac enlargement. He was submitted to angiography with coil embolization of gutters, obtaining a successfully result. At 1 and 3 months, he is free from endoleak, with a stable aneurysmal diameter.

Keywords: EVAS; embolization; type Ia endoleak.

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Conflict of interest statement

Disclosure StatementAll authors declare no conflict of interest.

Figures

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Fig. 1 Preoperative computed tomography image showing a voluminous infrarenal abdominal aortic aneurysm with a transverse diameter of 82×84 mm.
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Fig. 2 Increasing transverse diameter of the aneurysmal sac 2 years after endovascular aneurysm sealing.
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Fig. 3 Axial computed tomography (CT) image showing contrast medium between left renal artery stent and the two covered aortic stents after ChEVAS and proximal extension (A); persistent type Ia endoleak in different CT image views (B). Intraoperative angiographic image showing the final result after gutter embolization through coils (C).
See this image and copyright information in PMC

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