title: Abdominal aortic endograft proximal collapse resulting in aortic aneurysm rupture.
abstract: An 82-year-old man was transferred to our emergency department due to acute abdominal pain. He had undergone an endovascular abdominal aortic aneurysm repair (EVAR) six years ago. An intravenous contrast-enhanced abdominal computed tomography revealed the rupture of the abdominal aortic aneurysm (AAA) with a large retroperitoneal hematoma. A Talent (Medtronic, Santa Rosa, CA, USA) modular bifurcated endoprosthesis had vertically collapsed approximately 7 cm after losing its infrarenal fixation. As a result, it led to the repressurization of the aneurysm sac and rupture. The patient was successfully treated by placing three Talent (Medtronic) aortic cuffs. To our knowledge, this is the first reported case of endograft collapse that has manifested with aortic aneurysm rupture. Although they are gradually declining, considerable rates of complications create the 'Achilles' heel' of endovascular repair of AAAs. A lifelong follow-up strategy for patients treated for AAA with EVAR is essential for the early detection and treatment of complications of the procedure.
authors.affiliation: Department of Vascular Surgery, Athens University Medical School, Attikon University Hospital, Athens, Greece.
authors.forename: Konstantinos G
authors.initials: KG
authors.lastname: Moulakakis
authors.forename: Ilias
authors.initials: I
authors.lastname: Dalainas
authors.forename: Triantafillos G
authors.initials: TG
authors.lastname: Giannakopoulos
authors.forename: Efthimios
authors.initials: E
authors.lastname: Avgerinos
authors.forename: Christos D
authors.initials: CD
authors.lastname: Liapis
mesh_terms: D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001019:Aortic Rupture / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation; D057510:Endovascular Procedures; D006801:Humans; D008297:Male; D011475:Prosthesis Failure / Q000009:adverse effects*