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.

Dinoto E., Ferlito F., Urso F., Evola S., Bajardi G., Pecoraro F. (2021). Trans-limb embolization for treatment of Type 2 endoleak post EVAR: Case report. INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS, 85 [10.1016/j.ijscr.2021.106238].

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

Bajardi G.
Penultimo
;
Pecoraro F.
Ultimo
2021-08-31

Abstract

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.
31-ago-2021
Dinoto E., Ferlito F., Urso F., Evola S., Bajardi G., Pecoraro F. (2021). Trans-limb embolization for treatment of Type 2 endoleak post EVAR: Case report. INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS, 85 [10.1016/j.ijscr.2021.106238].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/517007
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