Successful Embolization of Persistent Endoleak from a Patent Inferior Mesenteric Artery

1997 ◽  
Vol 4 (3) ◽  
pp. 312-315 ◽  
Author(s):  
Greg van Schie ◽  
Kishore Sieunarine ◽  
Mike Holt ◽  
Michael Lawrence-Brown ◽  
David Hartley ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Aortic Aneurysm ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Abdominal Aortic ◽  
Contrast Enhanced ◽  
Retrograde Filling ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Purpose: To report the successful endovascular occlusion of a persistent endoleak owing to collateral perfusion in a 1-year-old bifurcated aortic endograft. Methods and Results: An 81-year-old man underwent endovascular repair of a 5.5-cm abdominal aortic aneurysm (AAA) with a bifurcated stent-graft in 1995; collateral perfusion of the excluded aneurysm by retrograde filling of the patent inferior mesenteric artery (IMA) was noted postoperatively. At his 1-year follow-up, the mid-sac endoleak persisted on contrast-enhanced computed tomography. Using the superior mesenteric artery for access, the stump of the IMA was successfully embolized with glue. Conclusions: This case, which highlights the importance of documenting a patent IMA prior to AAA endografting, illustrates one option for the management of persistent collateral perfusion of endovascularly excluded aneurysms.

Atypical Endoleak Associated With Inadvertent Cannulation of the Ipsilateral Gate in an Ovation Trimodular Stent-Graft

2017 ◽  
Vol 52 (2) ◽  
pp. 135-137 ◽  
Author(s):  
Geert Maleux ◽  
Sabrina Houthoofd ◽  
Lien Poorteman ◽  
Inge Fourneau
Keyword(s):  
Computed Tomography ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Stent Graft ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Endovascular Aortic Repair ◽  
Abdominal Aortic ◽  
The Right

We report on a 54-year-old man who presented with an atypical, proximal, intraoperative endoleak after endovascular aortic repair with an Ovation endograft for a 65-mm-diameter abdominal aortic aneurysm. The endografting was complicated by inadvertent bilateral iliac limb insertion into the right gate without cannulation of the left gate. The endoleak was treated by brachial approach: Through the open left gate, the outflow inferior mesenteric artery was coil embolized and the inflow left gate was closed with an Amplatzer plug. Follow-up computed tomography over 3 years showed absence of any endoleak and a stable diameter of the excluded abdominal aortic aneurysm.

Snorkel Technique for Inferior Mesenteric Artery During Endovascular Repair of Abdominal Aortic Aneurysm

2018 ◽  
Vol 52 (3) ◽  
pp. 233-236
Author(s):  
Serkan Ertugay ◽  
Ahmet Daylan ◽  
Halil Bozkaya ◽  
Emrah Oğuz ◽  
Anıl Apaydın ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Repair ◽  
Mesenteric Artery ◽  
Inferior Mesenteric Artery ◽  
Renal Arteries ◽  
Main Body ◽  
Maximal Diameter ◽  
Abdominal Aortic

Purpose: The snorkel technique is commonly used to preserve renal arteries in juxta renal aneurysm during endovascular repair. Herein, we present a patient who underwent bifurcated endograft implantation with snorkel technique for inferior mesenteric artery (IMA) in order to preserve the major source of bowel circulation. Case Report: A 69-year-old male patient was diagnosed with abdominal aortic aneurysm. His history revealed that he had bowel resection due to a car accident 30 years ago. In addition, he was given relaparotomy 4 times due to intestinal complications. Computed tomography showed fusiform aneurysm with a maximal diameter of 60 mm and chronical occlusion of the superior mesenteric artery. Inferior mesenteric artery was found to be hypertrophic. During EVAR, 6 mm × 10 cm covered VIABAHN Endoprosthesis (Gore Medical) was implanted to the IMA over a 0.018 guidewire via puncture of the left axillary artery. Initially, the main body of the aortic stent-graft (Gore C3, size 23-14-16) was implanted to the infra renal segment of the aorta (below the renal arteries and the orifice using VIABAHN) via the right femoral artery. Next, the contralateral leg (Gore, 14-12-00) was implanted. Computed tomography was examined at 1- and 32-month postoperatively, and no endoleak or patency of IMA stent was detected. Conclusion: In this case of IMA-dependent circulation of the intestinal system, the protection of IMA via snorkel technique was successful.

Effectiveness of the conservative therapy for spontaneous isolated iliac artery dissection: Preliminary results

Vascular ◽  
2017 ◽  
Vol 25 (6) ◽  
pp. 649-656 ◽  
Author(s):  
Zhuhong Liang ◽  
Weiwei Guo ◽  
Chunhua Du ◽  
Yingdi Xie
Keyword(s):  
Computed Tomography ◽  
Conservative Therapy ◽  
False Lumen ◽  
Artery Dissection ◽  
True Lumen ◽  
Contrast Enhanced ◽  
Entry Points ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Purpose To investigate the effectiveness of conservative therapy for spontaneous isolated iliac artery dissection (SIIAD). Methods From February 2006 to May 2016, all patients with SIIAD were included and analyzed. The diagnosis of SIIAD was made based on contrast-enhanced computed tomography. The imaging morphologic characteristics, treatments, and outcomes for each patient were analyzed. Results A total of 11 patients (10 male and 1 female, age 71.1 ± 7.8 years) were included in this study. Of the 11 patients, 8 patients were asymptomatic and the SIIADs were discovered during the course of computed tomography for other diseases, and 3 patients were symptomatic. Initial computed tomography findings: iliac arterial calcification ( n = 7); compression of the true lumen ( n = 6), with stenosis of the true lumen from 25% to 50% ( n = 3) and ≥ 50% ( n = 3); thrombosed false lumen partially ( n = 4), and no thrombosis in false lumen ( n = 7); dissecting aneurysm ( n = 11); entry points ( n = 11); re-entry points ( n = 1); no dissection extended to the internal iliac or common femoral artery. Conservative treatment was performed in six patients, and the remaining five patients need no treatment. During 23.3 ± 14.2 months follow-up, none recurred symptoms and signs of symptomatic SIIAD; partial remodeling of SIIAD was achieved in four patients, and the remaining seven patients with no change of SIIAD. There was no presence of new false lumen enhancement on contrast-enhanced computed tomography during follow-up. Conclusions SIIAD without arterial rupture or lower limb necrosis can be safely treated with conservative therapy.

Sign in / Sign up

Export Citation Format

Share Document