Intraoperative Findings of an Atypical Type II Endoleak from an Artery within the Aneurysmal Wall after Endovascular Aneurysm Repair

Abstract

A 75-year-old man underwent emergent endovascular aortic repair for a ruptured abdominal aortic aneurysm. Two years later, computed tomography revealed aneurysm enlargement with endoleaks. Next, late open conversion was performed. Intraoperatively, we detected a spurting type II endoleak from an artery within the aneurysmal wall, which was unconnected to any branch vessels outside the aneurysm, and surgical ligation and sacotomy was performed uneventfully. To our knowledge, this is the first report to intraoperatively identify a type II endoleak from an artery within the aneurysm wall. Even for atypical type II endoleak, such as this case, open surgical repair should be effective.

Surgical Treatment of Sac Enlargement Due to Type II Endoleaks Following Endovascular Aneurysm Repair

“…Furthermore, Torikai and Takahashi et al have published a case report of continuous aortic aneurysmal growth following EVAR caused by atypical T2EL without EL cavities through developed vasa vasorum, which are known as the vessels associated with arterial microcircula-Open Conversion for Repairing Type II EL after EVAR tion. 38,39) Thus, it is better to remove the aneurysmal wall to the extent possible in endoaneurysmorrhaphy.…”