title: Zenith Cook limb type IIIB endoleak causing aneurysm rupture five years after EVAR.
abstract: Type III endoleaks are rare late complications of endovascular abdominal aortic aneurysm repair. The aneurysm sac is pressurised either through disconnection of modular components (type IIIA) or a defect in the graft fabric (type IIIB). We report the endovascular treatment of a ruptured infrarenal aortic aneurysm five years after elective endovascular abdominal aortic aneurysm repair caused by a type IIIB endoleak secondary to probable graft material erosion of the contralateral limb. This is the first report of a late aneurysm rupture caused by fabric defect in a Cook Zenith limb. The case highlights the potential serious consequences of minimal migration of the device and the importance of landing the proximal fixation in healthy aorta.
authors.affiliation: Department of Interventional Radiology, Guy's and St. Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK North Bristol NHS Trust, Department of Radiology, Southmead Hospital, Bristol, UK drpetermezes@gmail.com.
authors.forename: Peter
authors.initials: P
authors.lastname: Mezes
authors.affiliation: Department of Vascular Surgery, Guy's and St. Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK.
authors.forename: Morad
authors.initials: M
authors.lastname: Sallam
authors.affiliation: Department of Interventional Radiology, Guy's and St. Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Diamantopoulos
authors.affiliation: Department of Vascular Surgery, Guy's and St. Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Taylor
authors.affiliation: Department of Interventional Radiology, Guy's and St. Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK.
authors.forename: Irfan
authors.initials: I
authors.lastname: Ahmed
mesh_terms: D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000150:complications*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D057867:Endoleak / Q000175:diagnosis / Q000209:etiology*; D057510:Endovascular Procedures / Q000009:adverse effects; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*; D012086:Reoperation
keywords: EVAR; Type IIIB endoleak; aneurysm rupture; complication; endovascular; stent