Treatment of a type IIIb endoleak in a Talent endograft using telescoping cuffs and two parallel upside-down excluder contralateral legs.
We describe a case of a type IIIb endoleak arising from the main body of a Talent endograft that was treated using two telescoping cuffs and two parallel upside-down inserted Excluder contralateral legs, thereby creating a new bifurcating endograft. First, a 23-mm cuff was deployed onto the flow divider of the Talent endograft, followed by a second 28-mm cuff below the renal arteries creating a tapering lumen. Two 20-mm Excluder contralateral limbs were then positioned upside-down in the 23-mm cuff and deployed simultaneously, creating a new bifurcated prosthesis. Control computed tomography (CT) scan at 6 weeks showed a good position of the endografts without signs of an endoleak. In conclusion, a type IIIb endoleak at the level of the flow divider may successfully be excluded using two telescoping cuffs and two parallel upside-down contralateral Excluder limbs. Due to the rarity of this complication, the treatment will always have to be tailor-made.
Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands. mmpj.reijnen@gmail.com
Michel M P J
MM
Reijnen
David J
DJ
Minion
Jan Willem H P
JW
Lardenoye
D000368:Aged; D015901:Angiography, Digital Subtraction; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D057867:Endoleak / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D011474:Prosthesis Design; D014057:Tomography, X-Ray Computed