Abdominal aortic aneurysm rupture following endoluminal graft deployment: report of a predictable event.
OBJECTIVE
To describe the predictability of an abdominal aortic aneurysm (AAA) rupture secondary to a type II endoleak following stent-graft exclusion.


RESULTS
An 81-year-old man with an enlarging AAA underwent endovascular repair using an AneuRx aortic stent-graft, but a type II endoleak fed by an accessory renal artery was detected at postprocedural computed tomography (CT). Surveillance CT scans at 6 and 16 months showed an increase in the aneurysm diameter and endoleak volume, but the patient refused advised treatment to close the leak. He suffered a fatal aneurysm rupture 24 months after endografting. Retrospective analysis of CT data documented progressive aneurysm enlargement that correctly predicted the rupture.


CONCLUSIONS
Type II endoleaks can lead to aneurysm rupture. Three-dimensional (3D) spiral CT angiography offers an opportunity to track endoleak volume and the effect of exposure to systemic pressure on the aneurysm sac.
White
R A
RA
Department of Surgery, Harbor-UCLA Medical Center, Torrance, California 90509, USA.
Donayre
C
C
Walot
I
I
Stewart
M
M
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation; D018450:Disease Progression; D006801:Humans; D008297:Male; D012077:Renal Artery / Q000002:abnormalities / Q000000981:diagnostic imaging; D012307:Risk Factors; D015607:Stents; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure