6533b826fe1ef96bd1283c07

RESEARCH PRODUCT

Trans-limb embolization for treatment of Type 2 endoleak post EVAR: Case report

S. EvolaGuido BajardiF. FerlitoEttore DinotoFelice PecoraroF. Urso

subject

medicine.medical_specialtyEndoleak type 2business.industrymedicine.medical_treatmentCoil embolizationmedicine.diseaseSize increaseInferior mesenteric arteryAneurysmSettore MED/22 - Chirurgia VascolareAbdominal aortic aneurysmSurgeryAneurysm ruptureLumbarAneurysmmedicine.arteryCase reportcardiovascular systemMedicineSurgerycardiovascular diseasesEmbolizationRisk factorbusiness

description

Introduction Type 2 endoleaks (T2EL) occur after 10%–25% of endovascular abdominal aortic aneurysm repairs and increase the risk factor of endograft repair failure and rupture. Herein we report a case of endovascular treatment of T2EL where we performed a trans-limb embolization. Presentation of case A 63-years-old male previously treated for AAA with endovascular aortic aneurysms repair (EVAR), showed an angio-CT scan followup with a type 2 endoleak fed from inferior mesenteric artery (AMI) with growth of AAA greater of 1 cm than preoperative CT-scan and increase of chronic lumbar pain. Due to high risk of rupture was performed a trans-limb embolization with complete sealing. The 6 months CT-angiography showed complete type 2 endoleak exclusion without changes of AAA. Discussion The risk of aneurysm rupture in the presence of an isolated T2EL is exceptionally low. However, when a persistent T2EL is associated with a significant sac size increase, commonly considered as at least 5 mm over 6 months, should be treated. Detachable coils are repositionable, allowing an extremely precise deployment and subsequent embolization of different targets. Conclusion In this experience trans-limb embolization was feasible and this tool should be taken in account especially when no other surgical options exists.

yearjournalcountryeditionlanguage
2021-08-31
10.1016/j.ijscr.2021.106238http://hdl.handle.net/10447/517007