title: Salvage antegrade visceral revascularization and antegrade aortic stenting for type I and III endoleaks after fenestrated juxtarenal aneurysm repair.
abstract: A 73-year-old man developed type I and III endoleaks from a fractured right renal stent with downward migration of a fenestrated endograft, 6 years after endovascular repair of a juxtarenal aneurysm. Endovascular treatment attempts were unsuccessful. He underwent aortic debranching and antegrade visceral artery revascularization via a left thoracolaparotomy incision and an extraperitoneal approach to the visceral aorta. An antegrade aortic stent covered the endoleak, with technical and clinical success at 9 months. Failure of complex endografts presents particular problems, potentially not amenable to totally endovascular repair. Continued surveillance is mandated as late, asymptomatic sac expansion can occur.
authors.affiliation: Addenbrooke's Hospital, Cambridge, United Kingdom.
authors.forename: Manjit S
authors.initials: MS
authors.lastname: Gohel
authors.forename: Martin
authors.initials: M
authors.lastname: Clark
authors.forename: Elika
authors.initials: E
authors.lastname: Kashef
authors.forename: Richard G J
authors.initials: RG
authors.lastname: Gibbs
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D057867:Endoleak / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D011475:Prosthesis Failure / Q000009:adverse effects; D015607:Stents / Q000009:adverse effects*