Surgical experience of persistent type 2 endoleaks with aneurysmal sac enlargement after endovascular aneurysm repair.
Herein, we present a case of a successful treatment of persistent type 2 endoleaks associated with aneurysmal sac enlargement after endovascular aneurysm repair in an elderly patient. We confirmed the diagnosis by abdominal computed tomography and selective angiography revealing an 11.0-cm aneurysm sac with type 2 endoleaks. An attempt for the endovascular embolization of collateral arteries was unsuccessful due to anatomic variations and their multiple complex communications. Instead, transperitoneal sacotomy and direct suturing on the feeding target vessels was successfully performed without any endograft damage. In conclusion, sacotomy appears to be a feasible therapeutic substitute where endovascular or other techniques have a high risk of failure and lead to unsuccessful results.
Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Korea.
Seung Ho
SH
Bang
Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Korea.
Jae Bum
JB
Park
Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Korea.
Hyun Keun
HK
Chee
Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Korea.
Jun Seok
JS
Kim
Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Korea.
Il Soo
IS
Jang
Complication; Endovascular stent; Prosthesis; Sacotomy