Complete Relining in Type 3 Endoleak with AFX Endograft Billowing and Severe Kinking: A Case Report.
Journal
Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
03
01
2020
revised:
12
06
2020
accepted:
22
06
2020
pubmed:
8
7
2020
medline:
1
12
2020
entrez:
8
7
2020
Statut:
ppublish
Résumé
Type 3 endoleak (T3E) is usually treated by endovascular relining. The procedure can be technically complex in cases of endografts with kinking of innermost stents. We report a case of T3E in an AFX (Endologix, Irvine, CA, USA) endograft with sac enlargement, billowing, and severe kinking of the main body stents, managed with a complete relining endovascular procedure. A 69-year-old man with severe comorbidities and prior aorto-bi-iliac AFX endograft completed by an Endurant II cuff (Medtronic, Santa Rosa, CA, USA) for a 63-mm asymptomatic infrarenal aneurysm was admitted to our department for a T3E with 7-mm sac enlargement. The computed tomography angiography (CTA) showed perfusion of the aneurysmal sac, AFX fabric disconnection from its stent (billowing), and severe stent kinking of the main body without a residual lumen. A digital subtraction angiography confirmed the T3E. A complete relining was performed by deploying a bifurcated Endurant II through the AFX stents. The 1-year CTA proved the resolution of the endoleak with a stable aneurysmal sac diameter. In case of T3E with severe main body stent kinking and graft billowing, an endovascular procedure with a complete aorto-bi-iliac relining through inner stents may be considered.
Sections du résumé
BACKGROUND
BACKGROUND
Type 3 endoleak (T3E) is usually treated by endovascular relining. The procedure can be technically complex in cases of endografts with kinking of innermost stents. We report a case of T3E in an AFX (Endologix, Irvine, CA, USA) endograft with sac enlargement, billowing, and severe kinking of the main body stents, managed with a complete relining endovascular procedure.
METHODS
METHODS
A 69-year-old man with severe comorbidities and prior aorto-bi-iliac AFX endograft completed by an Endurant II cuff (Medtronic, Santa Rosa, CA, USA) for a 63-mm asymptomatic infrarenal aneurysm was admitted to our department for a T3E with 7-mm sac enlargement. The computed tomography angiography (CTA) showed perfusion of the aneurysmal sac, AFX fabric disconnection from its stent (billowing), and severe stent kinking of the main body without a residual lumen. A digital subtraction angiography confirmed the T3E. A complete relining was performed by deploying a bifurcated Endurant II through the AFX stents.
RESULTS
RESULTS
The 1-year CTA proved the resolution of the endoleak with a stable aneurysmal sac diameter.
CONCLUSIONS
CONCLUSIONS
In case of T3E with severe main body stent kinking and graft billowing, an endovascular procedure with a complete aorto-bi-iliac relining through inner stents may be considered.
Identifiants
pubmed: 32634566
pii: S0890-5096(20)30555-0
doi: 10.1016/j.avsg.2020.06.054
pii:
doi:
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
451.e11-451.e16Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.