title: Laparoscopic transperitoneal clipping of the inferior mesenteric artery for the management of type II endoleak after endovascular repair of an aneurysm.
abstract: We report the case of a high risk patient with an abdominal infrarenal aortic aneurysm (AAA) who was treated by endovascular technique and the subsequent management of a type II endoleak by the laparoscopic approach. In this case, a 74-year-old woman with a 6-cm infrarenal AAA underwent endovascular repair using a bifurcated stent-graft device. Surveillance CT scan showed a persistent type II endoleak at 1 week and 3 months after the operation. Angiography confirmed retrograde flow from the inferior mesenteric artery (IMA). Attempted transarterial embolization of the IMA via the superior mesenteric artery was not successful. Laparoscopic transperitoneal IMA clipping was performed. Subsequent aortic duplex scan and CT scan confirmed complete elimination of the type II endoleak. We conclude that a combination of endovascular and laparoscopic procedures can be used to manage AAA successfully.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Center, Queen Mary Hospital, Hong Kong SAR, China.
authors.forename: P
authors.initials: P
authors.lastname: Ho
authors.forename: W L
authors.initials: WL
authors.lastname: Law
authors.forename: P H M
authors.initials: PH
authors.lastname: Tung
authors.forename: J T C
authors.initials: JT
authors.lastname: Poon
authors.forename: A C W
authors.initials: AC
authors.lastname: Ting
authors.forename: S W K
authors.initials: SW
authors.lastname: Cheng
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008638:Mesenteric Arteries / Q000601:surgery*; D017537:Mesenteric Artery, Inferior / Q000000981:diagnostic imaging / Q000601:surgery*; D015607:Stents; D014057:Tomography, X-Ray Computed