title: Nonvisualized type III endoleak masquerading as endotension: a case report.
abstract: Here, we describe a case of nonvisualized type III endoleak masquerading as endotension that was diagnosed by opening the aneurysm sac during surgery and successfully treated surgically. A 79-year-old man underwent endovascular aneurysm repair (EVAR) 4 years previously for an aneurysm that had enlarged gradually without endoleak. An open surgical operation was performed. The sac pressure was 132 mm Hg-similar to the preoperative systolic blood pressure-and nonpulsatile. After the aneurysm sac was opened without clamping the aorta, a type III endoleak from the suture point of the prosthetic endograft was detected. The prosthetic graft was successfully replaced with a Y-graft. The current findings suggest that nonvisualized type III endoleaks may be a potential cause of endotension.
authors.affiliation: Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan. Electronic address: akihiro197253@yahoo.co.jp.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yoshitake
authors.affiliation: Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hachiya
authors.affiliation: Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Takahito
authors.initials: T
authors.lastname: Itoh
authors.affiliation: Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kitahara
authors.affiliation: Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Mio
authors.initials: M
authors.lastname: Kasai
authors.affiliation: Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kawaguchi
authors.affiliation: Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D020878:Device Removal; D003937:Diagnosis, Differential; D057867:Endoleak / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome