A Case Report of Endoleak type Ib and IIIa Combination after Endovascular Subrenal Aneurysm Repair

Czech version

Authors: S. Jiška; T. Daněk; Z. Bělobrádek; D. Dobeš ¹; J. Raupach ²
Authors‘ workplace: Chirurgická klinika Lékařské fakulty UK v Hradci Králové a Fakultní nemocnice Hradec Králové, přednosta: doc. MUDr. A. Ferko, CSc. ; Fakulta vojenského zdravotnictví Univerzity obrany v Hradci Králové, děkan: plk. prof. MUDr. R. Prymula, Ph. D. ¹; Radiologická klinika Lékařské fakulty UK v Hradci Králové a Fakultní nemocnice Hradec Králové, přednosta: prof. MUDr. P. Eliáš, Ph. D. ²
Published in: Rozhl. Chir., 2010, roč. 89, č. 1, s. 24-27.
Category: Monothematic special - Original

Overview

Authors describe a case report of complications and theirs solutions after endovascular abdominal aneurysm repair. There was symptomatic progression of aneurysmal sac due to endoleak type Ib in this patient 4 years after successful stentgraft treatment. Endovascular treatment was done with optimal effect, but aneurysm sac rupture had early become. The patient was urgently operated. The cause of the rupture was endoleak type IIIa, that was diagnosed perioperatively. This complication was solved with direct suture of disconnected parts of stentgraft. Despite of postoperative complications the patient vas released home in a good condition after 23 days of hospital staying. Endoleaks and their management are discussed in the article.

Key words:
aneurysm of subrenal aorta – stentgraft – endoleak – aneurysm rupture

Sources

1. Moore, W. S. Vascular and Endovascular Surgery: A Comprohensive Review. 7th edition. Saunders, 2005, p. 488–507.

2. Ferko, A., Krajina, A. Arteriální aneuryzmata. ATD nakladatelství, Hradec Králové, 1999, s. 74–105.

3. Krajina, A., Peregrin, J. H. Intervenční radiologie. Miniinvazivní terapie. Olga Čermáková, Hradec Králové, 2005, s. 281–292.

4. Krajíček, M., Peregrin, J. H., Roček, M., Šebesta, P. Chirurgická a intervenční léčba cévních onemocnění. Grada Publishihg, Praha, 2007, s. 185–214.

5. Szmidt, J., Galazka, Z., Rowinski, O., et al. Late aneurysma rupture after endovascular abdominal aneurysm repair. Interact. Cardiovasc. Thorac. Surg., 2007 Aug, 6(4): p. 490–494.

6. Buth, J., Harris, P. L., van Marrewijk, C., Fransen, G. The significance and management of different types of endoleaks. Semin. Vasc. Surg., 2003, Vol. 16(2), p. 95–102.

7. Nes, J. G. H., Hendriks, J. M., Tseng, L. N. L., et al. Endoscopic Aneurysm Sac Fenestration as a Treatment Option for Growing Aneurysms Due to Type II Endoleak or Endotension. Journal of Endovascular Therapy: Vol. 12, No. 4, p. 430–434.

8. Raman, K. G., Missig-Carroll, N., Richardson, T., Muluk, S. C., Makaroun, M. S. Color-flow duplex ultrasound scan versus computed tomographic scans in the surveillance of endovascular aneurysm repair. J. Vasc. Surg., 2003 Oct, 38(4), p. 645–651.

9. Lawrence-Brown, M. M., Sun, Z., Semmens, J. B., et al. Type II endoleaks: when is intervention indicated and what is the index of suspicion for types I or III? J. Endovasc. Ther., 2009 Feb., 16 Suppl 1, p. 106–118.