title: EndoAnchors to Resolve Persistent Type Ia Endoleak Secondary to Proximal Cuff With Parallel Graft Placement.
abstract: OBJECTIVE
  To describe 2 patients with a distally migrated endograft causing a type Ia endoleak and treatment with a proximal cuff and chimney grafts that required EndoAnchors to finally seal the leak.
  
  
  METHODS
  Two men, ages 86 and 72 years, presented with stent-graft migration and type Ia endoleak at 5 and 15 years after endovascular repair, respectively. Both were treated with a proximal cuff in combination with a chimney graft to the left renal artery. In both cases, the type Ia endoleak persisted, likely due to gutter formation. Both patients were treated in the same setting with EndoAnchors that instantly resolved the endoleak. At 1-year follow-up, there was no recurrent endoleak or migration, with patent chimney grafts and renal arteries and stable renal function.
  
  
  CONCLUSIONS
  EndoAnchors may effectively resolve a persistent type Ia endoleak arising from gutter formation after placement of a proximal cuff and chimney grafts.
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands.
authors.forename: Esmé J
authors.initials: EJ
authors.lastname: Donselaar
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands.
authors.forename: Rozemarijn J
authors.initials: RJ
authors.lastname: van der Vijver-Coppen
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands.
authors.forename: Leo H
authors.initials: LH
authors.lastname: van den Ham
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands.
authors.forename: Jan Willem H P
authors.initials: JW
authors.lastname: Lardenoye
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands mmpj.reijnen@gmail.com.
authors.forename: Michel M P J
authors.initials: MM
authors.lastname: Reijnen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D057867:Endoleak / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: anchors; chimney graft; complication; endoleak; endovascular aneurysm repair; gutter; late endoleak; proximal cuff; stent-graft migration; type Ia endoleak