title: Ischemic skin ulceration complicating glue embolization of type II endoleak after endovascular aneurysm repair.
abstract: The optimal treatment for type II endoleaks remains unclear. The present report describes a case of ischemic skin ulceration after glue embolization of a type II endoleak with challenging access in a multiply comorbid 82-year-old woman with an expanding aneurysm sac 3 years after endovascular aneurysm repair. Embolization was performed from a proximal position with an n-butyl cyanoacrylate/Ethiodol mixture to allow flow into the endoleak because direct sac puncture was hazardous. One week after intervention, an eschar, which progressed to superficial necrosis as a result of partial nontarget delivery of sclerosant, developed over the left iliac crest. The eschar was self-limiting, with complete resolution by 6 months.
authors.affiliation: Leeds Vascular Institute, The General Infirmary at Leeds, Great George Street, Leeds LS1 3EX, UK. marc.bailey@doctors.org.uk
authors.forename: Marc A
authors.initials: MA
authors.lastname: Bailey
authors.forename: Simon J
authors.initials: SJ
authors.lastname: McPherson
authors.forename: Max A
authors.initials: MA
authors.lastname: Troxler
authors.forename: A Howard S
authors.initials: AH
authors.lastname: Peach
authors.forename: Jai V
authors.initials: JV
authors.lastname: Patel
authors.forename: D Julian A
authors.initials: DJ
authors.lastname: Scott
mesh_terms: D000369:Aged, 80 and over; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D004659:Enbucrilate / Q000009:adverse effects* / Q000627:therapeutic use*; D057867:Endoleak / Q000150:complications / Q000601:surgery*; D057510:Endovascular Procedures; D005260:Female; D006490:Hemostatics / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007511:Ischemia / Q000139:chemically induced* / Q000000981:diagnostic imaging; D011859:Radiography; D012867:Skin / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000187:drug effects; D012883:Skin Ulcer / Q000139:chemically induced* / Q000000981:diagnostic imaging; D014014:Tissue Adhesives / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D006490:Hemostatics; D014014:Tissue Adhesives; D004659:Enbucrilate