A novel alternative to open conversion for type 1 endoleak resulting in ruptured aneurysm.
In this article, a novel technique for the treatment of ruptured abdominal aortic aneurysm secondary to proximal type 1 endoleak as a result of progressive neck dilatation after endovascular aneurysm repair is reported. A 74-year-old man with multiple comorbidities including severe ischemic heart disease, congestive cardiac failure, and chronic renal failure presented with a ruptured abdominal aortic aneurysm. He had an infrarenal endovascular aneurysm repair performed in 1999 and had subsequently developed a proximal type 1 endoleak. At open laparotomy, the placement of 4 nylon ties around the infrarenal aneurysm neck to refashion a seal and exclude the sac from systemic pressurization effectively treated the rupture. In the high-risk patient, ruptured proximal type 1 endoleak can be successfully treated with external banding avoiding the potential morbidity seen with the aortic clamping and blood loss of open conversion.
Varcoe
Ramon L
RL
Department of Vascular Surgery, Prince of Wales Hospital and University of New South Wales, Randwick, New South Wales, Australia. ramonvarcoe@yahoo.com
Laird
Martin P
MP
Frawley
John E
JE
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000473:pathology / Q000601:surgery*; D001019:Aortic Rupture / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D004108:Dilatation, Pathologic; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome