title: Early Enlargement of Aneurysmal Sac and Separation of EndoBags of Nellix Endovascular Aneurysm Sealing System as Signs of Increased Risk of Later Aneurysm Rupture.
abstract: Nellix Endovascular Aneurysm Sealing (EVAS) system is a new concept and technology of abdominal aortic aneurysm (AAA) repair. Elective EVAS using Nellix device was performed for a 83-year-old man with AAA. 2-month post-EVAS CTA surveillance demonstrated mild enlargement of aneurysmal sac and separation of the EndoBags, but without detectable endoleak. The patient developed sudden AAA rupture with retroperitoneal hematoma at about 4 months after EVAS. We postulated that early enlargement of aneurysmal sac and separation of EndoBags of Nellix devices after EVAS, even without detectable endoleak, might indicate significant aneurysmal wall weakening with increased risk of later AAA rupture. To the best of the authors' knowledge, this was the first reported case of aortic rupture after EVAS without detectable endoleak during and after the procedure.
authors.affiliation: Department of Radiology, Princess Margaret Hospital, 2-10 Princess Margaret Hospital Road, Lai Chi Kok, Kowloon, Hong Kong SAR, China. rickieclf@yahoo.com.hk.
authors.forename: Lik Fai
authors.identifier: http://orcid.org/0000-0002-4127-533X
authors.initials: LF
authors.lastname: Cheng
authors.affiliation: Department of Surgery, Princess Margaret Hospital, Hong Kong SAR, China.
authors.forename: Kwok Fai
authors.initials: KF
authors.lastname: Cheung
authors.affiliation: Department of Surgery, Princess Margaret Hospital, Hong Kong SAR, China.
authors.forename: Kwong Man
authors.initials: KM
authors.lastname: Chan
authors.affiliation: Department of Radiology, Princess Margaret Hospital, 2-10 Princess Margaret Hospital Road, Lai Chi Kok, Kowloon, Hong Kong SAR, China.
authors.forename: Johnny Ka Fai
authors.initials: JKF
authors.lastname: Ma
authors.affiliation: Department of Radiology, Princess Margaret Hospital, 2-10 Princess Margaret Hospital Road, Lai Chi Kok, Kowloon, Hong Kong SAR, China.
authors.forename: Wing Hang
authors.initials: WH
authors.lastname: Luk
authors.affiliation: Department of Surgery, Princess Margaret Hospital, Hong Kong SAR, China.
authors.forename: Micah Chi King
authors.initials: MCK
authors.lastname: Chan
authors.affiliation: Department of Radiology, Princess Margaret Hospital, 2-10 Princess Margaret Hospital Road, Lai Chi Kok, Kowloon, Hong Kong SAR, China.
authors.forename: Carol Wing Kei
authors.initials: CWK
authors.lastname: Ng
authors.affiliation: Department of Radiology, Princess Margaret Hospital, 2-10 Princess Margaret Hospital Road, Lai Chi Kok, Kowloon, Hong Kong SAR, China.
authors.forename: Neeraj Ramesh
authors.initials: NR
authors.lastname: Mahboobani
authors.affiliation: Department of Surgery, Princess Margaret Hospital, Hong Kong SAR, China.
authors.forename: Wai Kin
authors.initials: WK
authors.lastname: Ng
authors.affiliation: Department of Radiology, Princess Margaret Hospital, 2-10 Princess Margaret Hospital Road, Lai Chi Kok, Kowloon, Hong Kong SAR, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Wong
mesh_terms: D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D057510:Endovascular Procedures / Q000295:instrumentation*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000601:surgery*; D011475:Prosthesis Failure; D012306:Risk; D015607:Stents; D013995:Time; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
keywords: Abdominal aortic aneurysm (AAA); Endovascular aneurysm repair (EVAR); Endovascular aneurysm sealing (EVAS)