Endograft fabric disintegration simulating a type II endoleak.
OBJECTIVE
To report a case of endograft disintegration misinterpreted as a type II endoleak.


METHODS
An 86-year-old man underwent successful Vanguard stent-graft implantation for a 49-mm abdominal aortic aneurysm. At 1 month, a distal type I endoleak was repaired, but another endoleak thought to arise from the lumbar or inferior mesenteric arteries remained. Multiple interventions to embolize the feeding arteries were unsuccessful, and the endoleak persisted. At 1 year, the leak was still present, and the aneurysm had increased to 69 mm. After failing to demonstrate the source of the leak radiographically, surgery was performed. At operation, the endoleak was traced to small holes in the graft fabric. The endograft was removed without difficulty, and the flow was re-established with an aortobi-iliac woven graft.


CONCLUSIONS
Chronically implanted stent-grafts can show signs of failure that are confusing or misleading. Correct diagnosis of endoleaks may be difficult, but every effort must be made to identify their source. It is vital that no enlarging aneurysm be left untreated.
Becquemin
Jean-Pierre
JP
Department of Vascular Surgery and Imaging, Hôpital Henri Mondor, Université Paris XII, Créteil, France. jpbecquemin@hotmail.com
Poussier
Bertrand
B
Allaire
Eric
E
Kobeiter
Hischam
H
Desgranges
Pascal
P
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000628:therapy; D001807:Blood Vessel Prosthesis; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic; D006801:Humans; D008161:Lumbosacral Region / Q000098:blood supply; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D011475:Prosthesis Failure; D011859:Radiography; D015607:Stents