A useful endovascular technique for treating modular limb disconnection in a bifurcated stent-graft.
OBJECTIVE
To report a technique for treating a type III endoleak owing to disconnection of an iliac graft limb from a modular aortic stent-graft.


METHODS
A hydrophilic guidewire is introduced via a homolateral femoral access and passed through the thrombosed iliac extension. Once the errant graft limb is recanalized, wire exchange for an extra stiff guidewire facilitates passage of an angioplasty balloon into the stent. Inflated under low pressure, the balloon is used to push the thrombosed limb retrograde into the aneurysm sac. With the aortoiliac axis restored, a new covered stent can be deployed.


CONCLUSIONS
This approach is one of several that may be used to treat a type III endoleak arising from a disconnected and occluded stent-graft limb. It avoids the bleeding complications of thrombolysis and restores the aortoiliac axis so that another stent-graft may be implanted to re-exclude the aneurysm.
Brouard
Remi
R
Department of Radiology, Centre Hospitalier Universitaire, Hĵpital de Rangueil, Toulouse, France.
Otal
Philippe
P
Soula
Philippe
P
Chabbert
Valérie
V
Chemla
Patricia
P
Leger
Philippe
P
Joffre
Francis
F
Rousseau
Hervé
H
D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000379:methods*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000628:therapy*; D001027:Aortography / Q000379:methods*; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D008297:Male; D011379:Prognosis; D011475:Prosthesis Failure; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome