Treatment of secondary stent-graft collapse after endovascular stent-grafting for iliac artery pseudoaneurysms.
We report the case of a patient who developed an asymptomatic pseudoaneurysm in the left external iliac artery after transplant nephrectomy. The pseudoaneurysm most probably arose as a suture aneurysm from the external iliac artery after removal of the graft renal artery. Obviously we can not exclude the possibility it was a true aneurysm, although this seems much less likely. The pseudoaneurysm was detected during a routine CT scan and was treated interventionally with a stent-graft. One month later the asymptomatic patient underwent a vascular ultrasound examination including color Doppler, power Doppler, and B-flow as a routine control. An endoleak with collapse of the stent-graft was diagnosed. There was no evidence of stent infection. At a reintervention, the pseudoaneurysm was successfully treated using two uncovered Palmaz stents at the proximal and distal edge of the stent graft. Peri- and post-interventional ultrasound and CT angiography confirmed the exclusion of the aneurysm without an endoleak.
Clevert
D-A
DA
Institute of Clinical Radiology, University of Munich - Grosshadern Campus, Marchioninistrasse 15, Munich, Germany. clevert@web.de
Stickel
M
M
Steitz
H-O
HO
Kopp
R
R
Strautz
T
T
Flach
P
P
Johnson
T
T
Jung
E M
EM
Jauch
K W
KW
Reiser
M
M
D000328:Adult; D017541:Aneurysm, False / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*; D011475:Prosthesis Failure; D015607:Stents / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed / Q000379:methods; D018608:Ultrasonography, Doppler / Q000379:methods