J Korean Soc Radiol.  2011 Aug;65(2):127-131. 10.3348/jksr.2011.65.2.127.

Vascular Rupture Caused by a Molding Balloon during Endovascular Aneurysm Repair: Case Report

• Lee HY
• Do YS
• Kim YW
• Park HS
• Park KB
• Kim DI

• KMID: 1443474
• DOI: http://doi.org/10.3348/jksr.2011.65.2.127

Abstract

Endovascular aneurysm repair (EVAR) has been accepted as an alternative to traditional open surgery in selected patients. Despite the minimally invasiveness of this treatment, several complications may occur during or after EVAR. Complications include endoleak, aortic dissection, distal embolism, or iatrogenic injury to the access artery. However, there are few reports on the vascular rupture caused by a molding balloon during EVAR. We report two cases of infrarenal abdominal aortic aneurysms complicated by procedure-related aortic or iliac artery rupture by the molding balloon during EVAR. In our cases, we observed suddenly abrupt increase of the diameter of the endograft during balloon inflation, because we inflated the balloon rapidly. In conclusion, careful attention must be paid during inflation of the molding balloon to prevent vascular rupture.

MeSH Terms

Aneurysm
Aortic Aneurysm, Abdominal
Aortic Rupture
Arteries
Embolism
Endoleak
Endovascular Procedures
Fungi
Humans
Iliac Artery
Inflation, Economic
Rupture

Figure

• 

  Fig. 1 A. Angiogram shows leakage of contrast medium due to the rupture of the right common iliac artery (black arrow). B. Additional extension of the graft limb (black arrow) to the external iliac artery was performed to exclude rupture of the common iliac artery. C. CTA performed on the sixth postoperative day shows the remaining hematoma in the retroperitoneum (white arrow) without showing an endoleak or active bleeding from the iliac artery. Note.-CTA = Computed tomographic angiography

• 

  Fig. 2 A. Angiogram after balloon dilatation showed proximal type I endoleak. To treat proximal type I endoleak, a second ballooning was attempted. B. Completion angiogram showed the extravasation of contrast medium from the proximal neck of the AAA (black arrows) just below the left renal artery. C. After inflation of the balloon, renal blood flow is preserved (black arrows) and no leakage of contrast medium from the aorta was confirmed by angiogram through the pigtail catheter in the suprarenal aorta. Note.-AAA = abdominal aortic aneurysm

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