Early type III endoleak with an Endurant endograft

Abouliatim, Issam; Gouicem, Djelloul; Kobeiter, Hicham; Majeski, Marek; Becquemin, Jean‐Pierre

doi:10.1016/j.jvs.2010.07.020

Cited by 23 publications

(17 citation statements)

References 10 publications

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“…We did not know the reason for the fabric defect after 14 months after the deployment. In the literature, there are reports about type 3b endoleaks with other aortic stent graft devices [9–11] but there was only one case report about early type 3b endoleak associated with Endurant endograft [12]. Our case is the first case of a late type 3b endoleak reported with an Endurant stent graft.…”

Section: Discussionmentioning

confidence: 73%

Late Type 3b Endoleak with an Endurant Endograft

Barburoğlu

Acunaş

Onal

et al. 2015

Case Reports in Radiology

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Endovascular stent grafting with different commercially available stent graft systems is widely applied for the treatment of abdominal aortic aneurysms with high success rates in the current era. Various types of endoleaks are potential complications of the procedure. They usually occur in the early period. In this report, we present type 3b endoleak occurring 14 months after a successful endovascular abdominal aortic aneurysm repair with a Medtronic Endurant stent graft.

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Section: Discussionmentioning

confidence: 73%

Late Type 3b Endoleak with an Endurant Endograft

Barburoğlu

Acunaş

Onal

et al. 2015

Case Reports in Radiology

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“…Indeed, there is the possibility to extend the proximal According to EUROSTAR data, 21,22 the incidence of late type III endoleak after successful EVAR is reported to be ~2% to 3%, and it has been reported with 3 commercially available endoprostheses. [23][24][25] The source of these endoleaks is difficult to identify and often requires multimodal imaging, as demonstrated in the illustrated case ( Figure 2A). Suspected type III endoleaks should be treated promptly, and in an analysis of preliminary EUROSTAR data, patients with late type III endoleaks had 9 times greater chance of aneurysm rupture compared with other registry patients.…”

Section: Discussionmentioning

confidence: 99%

Type IIIb Endoleak and Relining

et al. 2016

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Purpose: To examine the changes in distraction force following relining of a conventional abdominal aortic stent-graft with a type IIIb endoleak using the Nellix endovascular sealing device compared to a unilateral stent-graft. Methods:Relining is often used to repair type IIIb endoleaks, but the consequences to graft stability are unknown. A mathematical model was constructed based on pressure and volume flow through the stent-grafts, incorporating recognized distraction force equations. Steady flow was presumed at peak systolic pressures to calculate the maximum distraction force, with gravity ignored. Distraction forces for 28-to 36-mmdiameter stent-graft bodies with 16-mm limbs were calculated and compared to forces following relining with single and double Nellix devices or the Renu unilateral device.Results: Distraction forces for the 28-, 32-, and 36-mm stent-grafts prior to relining were 5.99, 10.21, and 14.99 N, respectively. Similar forces were reported after relining with bilateral Nellix devices (5.86, 10.08, and 14.86 N, respectively). However, use of a unilateral Nellix increased the distraction forces to 9.92, 14.14, and 18.92 N, respectively. These were comparable to the increase observed after relining with a Renu unilateral stent-graft (9.87, 14.09, and 18.86 N, respectively). The proportional increase in distraction force for a unilateral relining ranged from 26% to 66%, with the greatest increase noted in the smaller diameter main bodies. Conclusion:Relining a stent-graft with a type IIIb endoleak using bilateral Nellix devices does not increase the distraction force. However, a unilateral Nellix device or the Renu system could theoretically increase the distraction force by up to 66%, potentially risking migration and type Ia endoleak. In clinical practice, these results suggest that a relining with bilateral Nellix may have benefits over the Renu unilateral stent-graft.

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“…Late type III endoleaks 8 have been detected with various stent grafts, for example, with a Zenith Cook aortic stent graft due to a fabric tear or hole near the stent sutures, 4,9 with an Ancure stent graft (Guidant, Menlo Park, CA) 10,11 and an Excluder stent graft (Gore Medical, Flagstaff, AZ). 12 The first report of early type III endoleak with an ENDURANT stent graft (Medtronic) was reported by Abouliatim et al 13 Therefore, patients undergoing endovascular aortic repair should have lifelong follow-up, as endoleaks can be detected as late as 7 years postoperatively. Patients with documented aneurysmal expansion should be carefully monitored with suspicion of endoleak.…”

Section: Discussionmentioning

confidence: 99%

“…Angiography combined with a search using guide wires and catheters has also been useful in localizing an endoleak. 13…”

Section: Discussionmentioning

confidence: 99%

Endovascular Management of Type I Endoleak with Fenestrated Aortic “Cuff” and Afterwards Treatment of Endoleak Type III

Duvnjak

2015

Int J Angiol

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).Endovascular aortic repair (EVAR) avoids the disadvantages of major surgery such as a large incision, full heparinization, extracorporeal circulation, aortic cross-clamping, interference with respiratory function, and the need for massive blood transfusions. Endoleak remains a primary complications of EVAR, however, and occurs in 20 to 25% of the patients.1,2 EVAR patients thus undergo lifelong surveillance for the presence of aneurysm expansion and endoleaks, usually via computed tomographic angiography (CTA). 2We describe the endovascular management of an enlarged aneurysmal sac 3 years after EVAR due to combined endoleak of types 1 and 3. We needed to use a fenestrated aortic cuff, a main body graft extension, and an aortouniiliac converter device to seal the leak. This case highlights the potential challenges in identifying and treating type III endoleaks. Case ReportA 75-year-old man with a 5.5 cm infrarenal aortic aneurysm was electively treated in 2008 with an endovascular talent stent graft (Medtronic, Minneapolis, MN) measuring 28 mm in diameter. The patient course was uncomplicated and the final angiography showed no endoleak. At 3 months followup, the size of the aneurysmal sac had increased by a few millimeters, suggesting a type II endoleak. The patient was conservatively managed and kept under observation and at 1 year follow-up the aneurysmal sac size was unchanged.The patient was then lost to follow-up for 2 years but in 2011 a contrast-enhanced CT scan and angiography revealed a type Ia endoleak and 2 cm increase in the aneurysmal sac size (►Fig. 1). The proximal landing zone was too short, especially on the left side where the aneurysm neck was only 5 mm long. The patient underwent endovascular treatment where a fenestrated custom-made aortic cuff with diameter of 30 Â 58 mm (Cook, Bloomington, IN) and two fenestrations for the renal artery and a scallop for the superior mesenteric artery was placed according to the standard guidelines. Advanta stent grafts (Atrium, Netherlands) of 6 Â 22 mm on the right side and 7 Â 22 mm on the left side were placed in the renal arteries using a left femoral route. The guide wire was placed in the superior mesenteric artery through the left brachial artery to allow rapid arterial access in the event of AbstractEndovascular aortic repair (EVAR) has become preferable treatment of abdominal aortic aneurysms because of proven mortality reduction as well as complications reduction compared with open surgery. Endoleak remains a primary complication of EVAR, however, and occurs in 20 to 25% of the patients. EVAR patients thus undergo lifelong surveillance for the presence of aneurysm expansion and endoleaks usually via computed tomographic angiography. We describe the endovascular management of an enlarged aneurysmal sac size 3 years after EVAR due to combined endoleak of types 1 and 3. We needed to use a fenestrated aortic cuff, a main body graft extension, and an aortouniiliac converter device to seal the leak. This case highlights the potential challenges in id...

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Early type III endoleak with an Endurant endograft

Cited by 23 publications

References 10 publications

Late Type 3b Endoleak with an Endurant Endograft

Late Type 3b Endoleak with an Endurant Endograft

Type IIIb Endoleak and Relining

Endovascular Management of Type I Endoleak with Fenestrated Aortic “Cuff” and Afterwards Treatment of Endoleak Type III

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