Ann Surg Treat Res.  2014 Mar;86(3):161-164. 10.4174/astr.2014.86.3.161.

Relining technique for continuous sac enlargement and modular disconnection secondary to endotension after endovascular aortic aneurysm repair

• Lee MI
• Shin WY
• Choe YM
• Park JY
• Kim JY
• Jeon YS
• Cho SG
• Hong KC

• KMID: 2266897
• DOI: http://doi.org/10.4174/astr.2014.86.3.161

Abstract

Endotension is an unpredictable late complication of endovascular aortic aneurysm repair (EVAR). This case report will discuss the successful treatment of enlarged aneurysmal sac due to endotension using the relining technique. An 81-year-old male complained of nondecreasing huge aneurysm sac. He had undergone EVAR for infrarenal abdominal aortic aneurysm 7 years prior and no endoleak was found through follow-up. Initially computed tomography-guided sac aspiration was tried, but in vain, Relining using the double barrel technique and tubular endograft for modular diconnection, which was unexpectedly found in the original endograft, were performed sucessfully. During follow-up after the relining procedure, the size of aneurysm sac continued to decrease in size. The relining technique is effective mothod for treating endotension.

Keyword

Aortic aneurysm; Endovascular procedures; Endoleak; Complication

MeSH Terms

Aged, 80 and over
Aneurysm
Aortic Aneurysm*
Aortic Aneurysm, Abdominal
Endoleak
Endovascular Procedures
Follow-Up Studies
Humans
Male

Figure

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  Fig. 1 (A) Computed tomography (CT) angiography showing increased size of aneurymal sac (9.7 cm) without endoleak (B) Aspirate of aneurysmal sac content by CT guidance.

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  Fig. 2 (A) Computed tomography (CT) angiography just after aspiration showing markedly decreased size of aneurysmal sac (B) CT angiography one week after aspiration showing refilled sac.

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  Fig. 3 Endograft relining technique of previous stent-graft (14-mm- × 12-cm-sized both iliac limb).

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  Fig. 4 Serial plain X-ray of abdomen showing insidious modular migration (arrows). (A) Six years ago, just after endovascular aortic aneurysm repair. (B) Present, before sac aspiration.

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