Zenith Cook limb type IIIB endoleak causing aneurysm rupture five years after EVAR

Type III endoleaks are rare late complications of endovascular abdominal aortic aneurysm repair. The aneurysm sac is pressurised either through disconnection of modular components (type IIIA) or a defect in the graft fabric (type IIIB). We report the endovascular treatment of a ruptured infrarenal aortic aneurysm five years after elective endovascular abdominal aortic aneurysm repair caused by a type IIIB endoleak secondary to probable graft material erosion of the contralateral limb. This is the first report of a late aneurysm rupture caused by fabric defect in a Cook Zenith limb. The case highlights the potential serious consequences of minimal migration of the device and the importance of landing the proximal fixation in healthy aorta.

Download Full-text

Causes and outcomes of open conversion and aneurysm rupture after endovascular abdominal aortic aneurysm repair: can type ii endoleaks be dangerous?11No competing interests declared.

Journal of the American College of Surgeons ◽

10.1016/s1072-7515(01)01128-0 ◽

2002 ◽

Vol 194 (1) ◽

pp. S98-S102 ◽

Cited By ~ 41

Author(s):

Jacob Buth ◽

Peter L Harris ◽

Corine van Marrewijk

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Abdominal Aortic Aneurysm Repair ◽

Aneurysm Rupture ◽

Type Ii ◽

Open Conversion ◽

Competing Interests ◽

Abdominal Aortic ◽

Aneurysm Repair ◽

Aortic Aneurysm Repair

Download Full-text

Infrarenal abdominal aortic aneurysm rupture and severe symptomatic coronary artery disease: Rapid combined transdiaphragmatic off-pump coronary surgery and abdominal aortic aneurysm repair

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2004.10.031 ◽

2005 ◽

Vol 129 (6) ◽

pp. 1434-1435

Author(s):

Georges Fayad ◽

Thomas Modine ◽

Stephan Haulon ◽

Christophe Decoene ◽

Richard Azzaoui ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Abdominal Aortic Aneurysm Repair ◽

Aneurysm Rupture ◽

Off Pump ◽

Abdominal Aortic ◽

Symptomatic Coronary Artery Disease ◽

Artery Disease ◽

Aneurysm Repair ◽

Aortic Aneurysm Repair

Download Full-text

Aortic Wall Tension as a Predictive Factor for Abdominal Aortic Aneurysm Rupture: Improving the Selection of Patients for Abdominal Aortic Aneurysm Repair

Annals of Vascular Surgery ◽

10.1007/s100169910027 ◽

2000 ◽

Vol 14 (2) ◽

pp. 152-157 ◽

Cited By ~ 69

Author(s):

Aaron J. Hall ◽

Edward F.G. Busse ◽

Don J. McCarville ◽

John J. Burgess

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Aortic Wall ◽

Abdominal Aortic Aneurysm Repair ◽

Aneurysm Rupture ◽

Abdominal Aortic ◽

Aneurysm Repair ◽

Aortic Aneurysm Repair ◽

Selection Of Patients ◽

Selection Of

Download Full-text

Endovascular Repair of Late Abdominal Aortic Aneurysm Rupture Owing to Mixed-Type Endoleak Following Endovascular Abdominal Aortic Aneurysm Repair

Vascular ◽

10.2310/6670.2007.00021 ◽

2007 ◽

Vol 15 (3) ◽

pp. 167-171 ◽

Cited By ~ 3

Author(s):

Chris Klonaris ◽

Sotiris Georgopoulos ◽

Fotis Markatis ◽

Athanasios Katsargyris ◽

Chris Tsigris ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Endovascular Repair ◽

Aortic Rupture ◽

Abdominal Aortic Aneurysm Repair ◽

Aneurysm Rupture ◽

Main Body ◽

Abdominal Aortic ◽

Aneurysm Repair ◽

Aortic Aneurysm Repair

We report the successful endovascular repair of a ruptured abdominal aortic aneurysm (AAA) in a multimorbid patient 8 months after endovascular abdominal aortic aneurysm repair (EVAR). A 74-year-old man with a history of EVAR 8 months earlier presented with hypotension, severe back pain, and tenderness on abdominal palpation. A contrast-enhanced computed tomographic scan showed a large retroperitoneal hematoma and confirmed the diagnosis of secondary abdominal aortic rupture. Because the patient had severe comorbidities, the endovascular method was chosen for further management. Two stent grafts were placed appropriately to eliminate a type 1a and a type 3 endoleak owing to modular separation of the left iliac graft limb from the main body stent graft. An additional self-expanding stent was deployed in the solitary right renal artery to open its origin, which was partially overlapped by the proximal cuff. The patient was discharged on the tenth postoperative day and is alive and well 1 year postoperatively. This case indicates that endovascular repair is feasible not only in cases of primarily ruptured AAAs but also in secondarily ruptured AAAs after failure of EVAR.

Download Full-text

Aneurysm Rupture Is Independently Associated with Increased Late Mortality in Those Surviving Abdominal Aortic Aneurysm Repair

Journal of Surgical Research ◽

10.1006/jsre.2000.6037 ◽

2001 ◽

Vol 95 (1) ◽

pp. 50-53 ◽

Cited By ~ 23

Author(s):

Andris Kazmers ◽

Anthony J. Perkins ◽

Lloyd A. Jacobs

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Abdominal Aortic Aneurysm Repair ◽

Aneurysm Rupture ◽

Late Mortality ◽

Abdominal Aortic ◽

Aneurysm Repair ◽

Aortic Aneurysm Repair

Download Full-text

Abdominal aortic endograft proximal collapse resulting in aortic aneurysm rupture

Vascular ◽

10.1258/vasc.2010.cr0259 ◽

2011 ◽

Vol 19 (3) ◽

pp. 159-162 ◽

Cited By ~ 3

Author(s):

Konstantinos G Moulakakis ◽

Ilias Dalainas ◽

Triantafillos G Giannakopoulos ◽

Efthimios Avgerinos ◽

Christos D Liapis

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Abdominal Aortic Aneurysm Repair ◽

Aneurysm Rupture ◽

Intravenous Contrast ◽

Abdominal Aortic ◽

Contrast Enhanced ◽

Aneurysm Repair ◽

Aortic Aneurysm Repair

An 82-year-old man was transferred to our emergency department due to acute abdominal pain. He had undergone an endovascular abdominal aortic aneurysm repair (EVAR) six years ago. An intravenous contrast-enhanced abdominal computed tomography revealed the rupture of the abdominal aortic aneurysm (AAA) with a large retroperitoneal hematoma. A Talent (Medtronic, Santa Rosa, CA, USA) modular bifurcated endoprosthesis had vertically collapsed approximately 7 cm after losing its infrarenal fixation. As a result, it led to the repressurization of the aneurysm sac and rupture. The patient was successfully treated by placing three Talent (Medtronic) aortic cuffs. To our knowledge, this is the first reported case of endograft collapse that has manifested with aortic aneurysm rupture. Although they are gradually declining, considerable rates of complications create the ‘Achilles’ heel' of endovascular repair of AAAs. A lifelong follow-up strategy for patients treated for AAA with EVAR is essential for the early detection and treatment of complications of the procedure.

Download Full-text