title: Treatment of type III endoleak with an aortouniiliac stent graft.
abstract: The purpose of this study was to present a novel treatment method for repair of a type III endoleak due to separation of modular components of an AneuRx (Medtronic AVE, Sunnyvalle, CA) stent graft as a result of graft kinking. A 73-year-old male had undergone endovascular repair of a 8.2-cm abdominal aortic aneurysm (AAA) 2 years previously. An aortic extender cuff was required to secure the proximal graft. Computed tomographic (CT) follow-up revealed a type III endoleak at 6-month follow-up. Plain radiographs showed separation between the main graft body and the aortic extender cuff. A second custom-made 28 mm x 5.5 cm aortic extender cuff was placed to seal the type III endoleak. Follow-up CT showed a persistent endoleak with an increase in AAA size to 10.5 cm. The patient underwent remedial AAA repair with an aortouniiliac endograft placed within the previous stent graft and a femorofemoral bypass. At 3-month follow-up there was no detectable endoleak. This constitutes an alternative endovascular therapy for modular device separation (type-III endoleak) after endoluminal AAA repair in patients who cannot undergo repair with a second bifurcated graft.
authors.affiliation: Division of Vascular Surgery, Loma Linda University Medical Center, Loma Linda, CA 92354, USA. tteruya@ahs.llumc.edu
authors.forename: Theodore H
authors.initials: TH
authors.lastname: Teruya
authors.forename: Juan
authors.initials: J
authors.lastname: Ayerdi
authors.forename: Maurice M
authors.initials: MM
authors.lastname: Solis
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Abou-Zamzam
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Ballard
authors.forename: Robert B
authors.initials: RB
authors.lastname: McLafferty
authors.forename: Kim J
authors.initials: KJ
authors.lastname: Hodgson
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D017130:Angioplasty / Q000009:adverse effects*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D004864:Equipment and Supplies; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012008:Recurrence; D012086:Reoperation; D015607:Stents / Q000009:adverse effects*