title: Endovascular repair of late abdominal aortic aneurysm rupture owing to mixed-type endoleak following endovascular abdominal aortic aneurysm repair.
abstract: We report the successful endovascular repair of a ruptured abdominal aortic aneurysm (AAA) in a multimorbid patient 8 months after endovascular abdominal aortic aneurysm repair (EVAR). A 74-year-old man with a history of EVAR 8 months earlier presented with hypotension, severe back pain, and tenderness on abdominal palpation. A contrast-enhanced computed tomographic scan showed a large retroperitoneal hematoma and confirmed the diagnosis of secondary abdominal aortic rupture. Because the patient had severe comorbidities, the endovascular method was chosen for further management. Two stent grafts were placed appropriately to eliminate a type 1a and a type 3 endoleak owing to modular separation of the left iliac graft limb from the main body stent graft. An additional self-expanding stent was deployed in the solitary right renal artery to open its origin, which was partially overlapped by the proximal cuff. The patient was discharged on the tenth postoperative day and is alive and well 1 year postoperatively. This case indicates that endovascular repair is feasible not only in cases of primarily ruptured AAAs but also in secondarily ruptured AAAs after failure of EVAR.
authors.affiliation: 1st Department of Surgery, LAIKON Hospital, Athens University Medical School, Greece. cklonaris@yahoo.com
authors.forename: Chris
authors.initials: C
authors.lastname: Klonaris
authors.forename: Sotiris
authors.initials: S
authors.lastname: Georgopoulos
authors.forename: Fotis
authors.initials: F
authors.lastname: Markatis
authors.forename: Athanasios
authors.initials: A
authors.lastname: Katsargyris
authors.forename: Chris
authors.initials: C
authors.lastname: Tsigris
authors.forename: Elias
authors.initials: E
authors.lastname: Bastounis
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001019:Aortic Rupture / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012008:Recurrence; D012187:Retroperitoneal Space; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome