Direct insertion of Amplatzer plugs to control lumbar arteries during open repair of type II endoleaks.
Type II endoleak after endovascular repair of an infrarenal aortic aneurysm (EVAR) may be difficult to diagnose and treat in the best of circumstances. Management is more difficult in the patient with significant renal insufficiency. We report an 81-year-old man with stage IV chronic kidney disease and a rapidly expanding, asymmetric aortic aneurysm sac, 31 months after EVAR. A type II lumbar endoleak was diagnosed by duplex ultrasound imaging and managed successfully with open aortic exposure and direct insertion of Amplatzer plugs into two bleeding lumbar arteries due to complex anatomic factors.
Department of Surgery, University of California, Davis, Sacramento, CA 95817, USA.
Kimberly
K
Evans
Anne C
AC
Kim
William C
WC
Pevec
D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001158:Arteries / Q000503:physiopathology; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D057867:Endoleak / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects*; D004867:Equipment Design; D006801:Humans; D008159:Lumbar Vertebrae / Q000098:blood supply*; D008297:Male; D012039:Regional Blood Flow; D051436:Renal Insufficiency, Chronic / Q000150:complications; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex