title: Surgical Treatment of Endotension after Chimney Endovascular Repair of a Symptomatic Juxtarenal Aneurysm.
abstract: Endoleaks and persistent aneurysm sac expansion, also known as endotension, remain the Achilles heel of endovascular aneurysm repair (EVAR). The present article reports on a surgical treatment of 1 patient with endotension after chimney EVAR for a symptomatic juxtarenal aortic aneurysm. The surgical exploration revealed no signs of inflammation or infection and excluded any endoleak, confirming the term "endotension". After 1 year, the absence of sac expansion or endoleak was confirmed, with stable maximum diameter. Regarding therapeutic options, a nonoperative approach is recommended in asymptomatic patients. However, the management strategy for sac expansion without evidence of endoleaks as in case of endotension remains controversial.
authors.affiliation: Department of Vascular Surgery, St. Franziskus Hospital Münster and University of Münster, Münster, Germany. Electronic address: konstantinos.donas@googlemail.com.
authors.forename: Konstantinos P
authors.initials: KP
authors.lastname: Donas
authors.affiliation: Department of Vascular Surgery, St. Franziskus Hospital Münster and University of Münster, Münster, Germany.
authors.forename: Elena
authors.initials: E
authors.lastname: Marchiori
authors.affiliation: Department of Vascular Surgery, St. Franziskus Hospital Münster and University of Münster, Münster, Germany.
authors.forename: Mirjam
authors.initials: M
authors.lastname: Inchingolo
authors.affiliation: Department of Vascular Surgery, St. Franziskus Hospital Münster and University of Münster, Münster, Germany.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Torsello
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome