title: Minimally invasive surgical solution in the treatment of an unusual distal type I endoleak after endovascular abdominal aortic aneurysm repair.
abstract: Most distal type I endoleaks can be treated by endovascular techniques such as coil embolization of the hypogastric artery and additional stent or extension stent grafts. We report a case of a difficult type I endoleak located in the distal end of a monoiliac conical stent graft used to treat an abdominal aortic aneurysm extensively involving both common iliac arteries. Cranial migration of the endograft and incarceration in the contralateral iliac aneurysm were observed on the computed tomographic scan. The patient was submitted to a procedure that involves endovascular and limited open surgery techniques. A 26 mm balloon catheter was used to secure the proximal implantation site, and through a Gibson incision, the iliac arteries were controlled. An interpositional 8 mm regular Dacron graft was then sutured end to end between the endograft and the external iliac artery.
authors.affiliation: Department of Surgery, Hospital de Clinicas de Porto Alegre-RS, Section of Vascular Surgery, Federal University of RGs, Porto Alegre, Brazil.
authors.forename: Adamastor Humberto
authors.initials: AH
authors.lastname: Pereira
authors.forename: Luiz Francisco Machado
authors.initials: LF
authors.lastname: da Costa
authors.forename: Gilberto Gonçalves
authors.initials: GG
authors.lastname: de Souza
authors.forename: Alexandre Araujo
authors.initials: AA
authors.lastname: Pereira
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002404:Catheterization; D003131:Combined Modality Therapy; D005548:Foreign-Body Migration / Q000601:surgery; D006801:Humans; D017543:Iliac Aneurysm / Q000601:surgery; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D015607:Stents