Endotension after endovascular treatment of abdominal aortic aneurysm: Percutaneous treatment

Abstract

Endotension is one of the possible specific late complications of endovascular treatment of abdominal aortic aneurysm (AAA). We describe the treatment of endotension in a small group of 3 patients (all men, aged 58, 70, and 70-years-old) by translumbar puncture of the aneurysm sac and aspiration of its content. It was transudate and its culture was negative. Sac size reduced after aspiration in all patients and no subsequent enlargement was seen. Percutaneous translumbar puncture of the aneurysm sac with aspiration of sac content could be an easy and effective method of treatment in endotension. But a larger group of patients and long-term follow-up are needed.

An in Vitro Twist Fatigue Test of Fabric Stent-Grafts Supported by Z-Stents vs. Ringed Stents

“…However, twisting may cause yarn shifting, possibly allowing blood percolation through the fabric. Percolation of low volumes of blood through multiple sites of damage to the fabric may explain the endotension phenomenon [59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84]. …”

Back Table Modification of Bifurcated Endurant Stent Graft to Aorto-Uni-Iliac Stent Graft to Treat Chronic Failure of Endovascular Abdominal Aortic Repair (EVAR) for Abdominal Aortic Aneurysm

“…The greater adaptability of this approach also allows for endovascular treatment of chronic pseudoaneurysms that form at proximal anastomotic sites after Y-graft repair for AAA; such pseudoaneurysms can exhibit similar anatomical challenges to failed cases after EVAR [4]. The other non-surgical options to address this rare complication of endotension include relining of the previous stent graft [5], or adding an aortic cuff to the proximal neck, performing a di-rect sac puncture and then aspirating the aneurysm sac or injecting it with glue [6]. However, the number of reported cases using these alternatives are limited; therefore, it remains controversial whether it is better to treat endotension with surgical conversion or endovascular treatment.…”

Aneurysm growth after late conversion of thoracic endovascular aortic repair

“…Therefore, we do not think that this patient is likely to develop any critical complications, such as shock due to rupture. 5 However, further enlargement of aneurysm sac can lead to enlargement landing zones or deformation of the aorta, and they can lead to migration or disintegration of stent graft. 5 If further enlargement occurs and re-intervention seems to be required with undetectable endoleaks, we will perform intra-arterial digital subtraction angiography with the catheter tip at different levels of the prosthesis to detect faint endoleaks.…”