Aortoenteric Fistula Due to Endoleak Coil Embolization after Endovascular AAA Repair

2003 ◽  
Vol 10 (1) ◽  
pp. 130-135 ◽  
Author(s):  
Daniel J. Bertges ◽  
Edward R. Villella ◽  
Michel S. Makaroun
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Coil Embolization ◽  
Late Complication ◽  
Aortoenteric Fistula ◽  
Type I ◽  
Computed Tomographic ◽  
Attachment Sites ◽  
Abdominal Aortic ◽  
Type I Endoleak

Purpose: To report a late complication associated with embolization coils used to treat an endoleak after endovascular abdominal aortic aneurysm (AAA) repair. Case Report: A 79-year-old man with a 5.8-cm AAA underwent endovascular repair with an Ancure graft in 1997. A persistent type I endoleak was identified on serial postoperative computed tomographic scans. Three transarterial coil embolization procedures were performed to treat an endoleak from the proximal and right distal attachment sites with outflow by the inferior mesenteric and lumbar arteries. Coil embolization was ultimately successful in sealing the endoleak, and the AAA decreased in size. Four years later, the patient developed an aortoenteric fistula due to erosion of the metallic embolization coils into the duodenum. The endograft was explanted and an extra-anatomical bypass inserted. Conclusions: Coil embolization to treat endoleaks can, on rare occasions, be the cause of aortoenteric fistula. Lifelong follow-up of stent-graft patients is required.

Treatment of a type Ia endoleak following EVAR using a custom-made inner branch device.

Vascular ◽  
2021 ◽  
pp. 170853812110627
Author(s):  
Gino Gemayel GG ◽  
Michel Montessuit MM ◽  
Anouche Gemayel GA
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Open Surgery ◽  
Type I ◽  
Novel Technology ◽  
Abdominal Aortic ◽  
Custom Made ◽  
Type Ia ◽  
Type I Endoleak ◽  
Aortic Cuff

Objectives We represent two cases of late proximal type I endoleak following EVAR with aneurysm expansion that were treated with a custom-made graft with inner branches. Methods Two patients of 87 and 82 years old were operated by EVAR 6 and 8 years ago for abdominal aortic aneurysm. Both had proximal type I endoleak with aneurysm sac expansion. Open surgery had a high risk, and a proximal aortic extension with a simple aortic cuff was not possible neither because previous EVAR grafts were already at the level of the renal arteries. A custom-made endograft with inner branches was planned as a fenestrated graft was not technically possible. Results We successfully treated both patients using a custom-made graft with four inner branches from Jotec (Cryolife, Kennesaw, GA). Three months’ follow-up CT scan did not show any endoleaks. All target vessels were patent with good conformability of the bridging stents. Conclusion The treatment of proximal type I endoleak using inner branches’ endografts is feasible. This novel technology might broaden the indications for complex aortic repair in a group of patients where fenestrated endografts are not possible.

Minimally Invasive Surgical Solution in the Treatment of an Unusual Distal Type I Endoleak after Endovascular Abdominal Aortic Aneurysm Repair

Vascular ◽  
2005 ◽  
Vol 13 (6) ◽  
pp. 362-364 ◽  
Author(s):  
Adamastor Humberto Pereira ◽  
Luiz Francisco Machado da Costa ◽  
Gilberto Gonçalves de Souza ◽  
Alexandre Araujo Pereira
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Balloon Catheter ◽  
External Iliac Artery ◽  
Abdominal Aortic Aneurysm Repair ◽  
Type I ◽  
Iliac Arteries ◽  
Computed Tomographic ◽  
Abdominal Aortic ◽  
Type I Endoleak

Most distal type I endoleaks can be treated by endovascular techniques such as coil embolization of the hypogastric artery and additional stent or extension stent grafts. We report a case of a difficult type I endoleak located in the distal end of a monoiliac conical stent graft used to treat an abdominal aortic aneurysm extensively involving both common iliac arteries. Cranial migration of the endograft and incarceration in the contralateral iliac aneurysm were observed on the computed tomographic scan. The patient was submitted to a procedure that involves endovascular and limited open surgery techniques. A 26 mm balloon catheter was used to secure the proximal implantation site, and through a Gibson incision, the iliac arteries were controlled. An interpositional 8 mm regular Dacron graft was then sutured end to end between the endograft and the external iliac artery.

Deployment Finesse of the Cook Zenith Stent Graft

2018 ◽  
Author(s):  
John Fritz Angle
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Stent Graft ◽  
Evidence Based ◽  
Type I ◽  
Stent Grafts ◽  
Standards Of Practice ◽  
Abdominal Aortic ◽  
Type I Endoleak

For all abdominal aortic aneurysm endografts, the major challenge is minimizing the risk of a type I endoleak. Percutaneous placement of an abdominal aortic endograft has become a widely-performed procedure. With several devices available on the market, there are many device-specific and experience-based considerations in planning and performing these procedures safely and with good outcomes. Although not always evidence-based, reviewing some case-specific scenarios can introduce techniques or lead to standards of practice that reduce suboptimal outcomes or prevent complications in future procedures. This chapter discusses deployment finesse of the Cook Zenith Flex and Zenith LP stent grafts, but many of the described concepts apply to other abdominal endografts and even thoracic endograft procedures.

Proximal Type I Endoleak After Endovascular Abdominal Aortic Aneurysm Repair: Predictive Factors

2004 ◽  
Vol 18 (6) ◽  
pp. 621-628 ◽  
Author(s):  
Sergio M. Sampaio ◽  
Jean M. Panneton ◽  
Geza I. Mozes ◽  
James C. Andrews ◽  
Thomas C. Bower ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Predictive Factors ◽  
Abdominal Aortic Aneurysm Repair ◽  
Type I ◽  
Abdominal Aortic ◽  
Type I Endoleak ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Uncovered Chimney Stent Graft for Renal Arteries With the Nellix Endovascular Aneurysm Sealing Technique

2017 ◽  
Vol 52 (2) ◽  
pp. 148-153 ◽  
Author(s):  
Luca Garriboli ◽  
Antonio Maria Jannello
Keyword(s):  
Aortic Aneurysms ◽  
Type I ◽  
Abdominal Aortic ◽  
Vessel Patency ◽  
Type I Endoleak ◽  
Procedural Costs ◽  
Endovascular Approach ◽  
Access Complications

Purpose: To describe the application of uncovered chimney stent grafts with the Nellix endovascular aneurysm sealing technique (ChEVAS) for juxtarenal abdominal aortic aneurysms (JAAAs). Case Report: Two patients with JAAA and multiple comorbidities were considered unfit for open surgery and were selected for an endovascular approach. Fenestrated and branched endografts were too expensive, and a chimney endovascular approach was considered inappropriate for the relatively high incidence of proximal type I endoleak and graft migration. ChEVAS was performed successfully with the novel addition of uncovered chimney stents to further reduce costs and possibly improve target vessel patency. JAAA exclusion and visceral vessel patency was confirmed at 18-month follow-up. Conclusion: ChEVAS with bare chimney stents is technically less complex, potentially reduces access complications and procedural costs, and may improve long-term patency compared to alternative techniques. Results at 18 months seem promising, but strict follow-up is necessary as the long-term durability is unknown.

Rescue EVAR for ruptured AAA: Clinical success does not mean technical success

Vascular ◽  
2013 ◽  
Vol 22 (5) ◽  
pp. 368-370 ◽  
Author(s):  
Francesco Setacci ◽  
Pasqualino Sirignano ◽  
Gianmarco de Donato ◽  
Giuseppe Galzerano ◽  
Carlo Setacci
Keyword(s):  
Emergency Department ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Wall ◽  
Clinical Success ◽  
Type I ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Technical Success ◽  
Abdominal Aortic ◽  
Good Clinical Condition

We report a clinical evolution of a 85-years old male admitted to our Emergency Department for ruptured abdominal aortic aneurysm (rAAA). One month later a huge type I proximal endoleak was detected and corrected by proximal aortic extension. We decided to fix the stent-graft to the aortic wall using EndoAnchors. However, an asymptomatic type III endoleak due to controlateral limb disconnection was detected at the followed schedulated CT angio and corrected by a relining of the endograft. The patient is now in good clinical condition with no evidence of endoleaks at 1-year follow-up.

Type I Endoleak Five Year after Endovascular Repair of Abdominal Aortic Aneurysm

2011 ◽  
Vol 27 (2) ◽  
pp. 76-79 ◽  
Author(s):  
Ei Jun Park ◽  
Hyoung Tae Kim ◽  
Won Hyun Cho ◽  
Young Hwan Kim
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Repair ◽  
Type I ◽  
Abdominal Aortic ◽  
Type I Endoleak

Changing Aneurysmal Morphology after Endovascular Grafting: Relation to Leakage or Persistent Perfusion

1997 ◽  
Vol 4 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Martin Malina ◽  
Krasnodar Ivancev ◽  
Timothy A.M. Chuter ◽  
Mats Lindh ◽  
Toste Länne ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Spiral Computed ◽  
Computed Tomographic ◽  
Aneurysm Size ◽  
Abdominal Aortic ◽  
Echo Tracking ◽  
Reduced Risk ◽  
Endovascular Grafting

Purpose: To relate changing abdominal aortic aneurysm (AAA) morphology after endovascular grafting to the presence of leakage, collateral perfusion, and other factors. Methods: Thirty-five patients who underwent successful AAA endovascular grafting were evaluated. Self-expanding Z-stents and Dacron grafts were applied in bifurcated and aortomonoiliac systems. Postoperative diameter changes were calculated from repeated spiral computed tomographic scans, angiograms, and ultrasonic phase-locked echo-tracking scans during a median 6-month follow-up (interquartile range [IQR] 3 to 12). Results: At 12 months, the diameters of completely excluded aneurysms had decreased 6 mm (IQR 2 to 11; p = 0.006). The proximal graft-anchoring stents had dilated 2 mm (IQR 0.5 to 3.3; p = 0.01). The aortic diameters immediately below the renal arteries but above the stents had not changed. Endoleakage and collateral perfusion (n = 13) were each associated with preserved aneurysm size and a 12 times higher risk of aneurysm dilation. After the leakage or the collateral perfusion had been treated, the aneurysm size decreased. Aneurysms with extensive intraluminal thrombi presented a reduced risk of leakage or perfusion. Conclusions: The diameters of endovascularly excluded AAAs decrease, except in cases of leakage or perfusion. Careful follow-up of patients with aortic endografts is necessary.

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