Type IIIB Endoleak 19 Years After Thoracic Endovascular Aneurysm Repair

Sala, Daniel Gil; Valenzuela, V. Fernández

doi:10.1016/j.ejvs.2018.07.039

Cited by 2 publications

(1 citation statement)

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“…It results from the mechanical failure of the stent graft, which may occur due to modular disjunction, fabric tear, or stent fracture. 9 Depending on the location and individual aortic anatomy of the endoleak, treatment options using traditional stent grafts may be limited. We present a case of a patient with Type IIIb endoleak from fabric tear of the original endograft just above the flow divider, who was treated with a custom-made device (CMD) with inverted limb technology, allowing for a bifurcated solution and avoiding the use of an aorto-uni-iliac (AUI) stent graft.…”

Section: Introductionmentioning

confidence: 99%

Treatment of a Delayed Type IIIb Endoleak 20 Years Post EVAR With Inverted Contralateral Limb Custom-Made Device: A Case Report

Linn

Tay

et al. 2022

J Endovasc Ther

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Purpose: Type III endoleak can be difficult to distinguish from Type I endoleak. Depending on the stent graft anatomy, the use of standard bifurcated endografts may not be technically feasible, and patients may have to be subject to an aorto-uni-iliac repair with femoral-femoral bypass or open surgery. Case Report: We report a case of an 86-year-old male who had a Type IIIb endoleak 20 years post EVAR which was characterized on angiography to be from a hole close to the bifurcation limb origin. The initial Talent (Medtronic, Santa Rosa, California) device had a 50 mm main body common trunk, which was not amenable to treatment with standard devices. He was successfully treated with a custom-made device with an inverted contralateral limb. Conclusions: Our case highlights the need for lifelong surveillance post EVAR as endoleak may present decades post initial EVAR. It also demonstrates that many Type III endoleak which were otherwise deemed unsuitable for treatment with standard devices may potentially be treatable with custom-made device (CMD). This solution preserves a percutaneous option in a now older person which avoids surgical bypass. Further studies are required to establish the durability of this treatment and survey for recurrence.

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Section: Introductionmentioning

confidence: 99%