Type I Endoleak-like Phenomenon Causing Rupture of the Replaced Aneurysm Sac 12 Years after Open Repair of Abdominal Aortic Aneurysm

Late Type IA Endoleak after Open Surgical Repair of an Aortic Aneurysm Leading to Rupture: Does this Really Exist?

“…1 The most delayed reported complication of this kind occurred 12 years postoperatively with the patient showing progressive aneurysm enlargement in a CT four months before the frank rupture. 2 At that time, absence of intrasac contrast falsely reassured treating physicians about the benign nature of the finding, similar to our case. 2 Subsequently, a high index of suspicion is necessary to correctly identify "surgical endoleaks" and avoid the disastrous complication of late aneurysm rupture because the diagnosis may or may not be evident on the CT. For example, Chan et al reported a patient who presented with abdominal pain, in whom imaging indicated increased sac dimensions but no evidence of a leak.…”

“…Nonetheless, there are scarce reports in the literature that describe endoleak-type phenomena after open surgery which mimic either type I or type II endoleaks, with blood flow inside the remnant aneurysm sac. 1,2 We aim to report a rare case of a patient who presented with frank rupture of an AAA, after a previous open surgical repair that was performed eight years ago. The patient presented a proximal site leak, leading to a recurrent aneurysm sac similar to a Type IA endoleak.…”

A complication of open abdominal aortic aneurysm repair closely resembling a type II endoleak

“…3 The most delayed presentation in the literature is a type 1 leak presenting as a rupture 12 years after surgery. 5 Type II endoleak can be subdivided into those involving a single vessel (type IIa) or multiple vessels (type IIb). 6 8 We believe this is the first reported case of a type II endoleak from the IMA.…”

Successful endovascular management of endoleak-like phenomenon following open abdominal aortic aneurysm repair

“…The timing of endoleak detection following open repair of AAA varies, ranging up to 12 years for detection of type I endoleak-like phenomenon presenting as a rupture [6]. This raises the issue of optimal follow-up after open AAA repair.…”