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A Novel Alternative to Open Conversion for Type 1 Endoleak Resulting in Ruptured AneurysmDepartment of Vascular Surgery, Prince of Wales Hospital and University of New South Wales, Randwick, New South Wales, Australia, ramonvarcoe{at}yahoo.com
Department of Vascular Surgery, Prince of Wales Hospital and University of New South Wales, Randwick, New South Wales, Australia
Department of Vascular Surgery, Prince of Wales Hospital and University of New South Wales, Randwick, New South Wales, Australia In this article, a novel technique for the treatment of ruptured abdominal aortic aneurysm secondary to proximal type 1 endoleak as a result of progressive neck dilatation after endovascular aneurysm repair is reported. A 74-year-old man with multiple comorbidities including severe ischemic heart disease, congestive cardiac failure, and chronic renal failure presented with a ruptured abdominal aortic aneurysm. He had an infrarenal endovascular aneurysm repair performed in 1999 and had subsequently developed a proximal type 1 endoleak. At open laparotomy, the placement of 4 nylon ties around the infrarenal aneurysm neck to refashion a seal and exclude the sac from systemic pressurization effectively treated the rupture. In the high-risk patient, ruptured proximal type 1 endoleak can be successfully treated with external banding avoiding the potential morbidity seen with the aortic clamping and blood loss of open conversion.
Key Words: abdominal aortic aneurysm • stent graft • endoleak
Vascular and Endovascular Surgery, Vol. 42, No. 4,
391-393 (2008) |
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