A Benign but Unusual Radiological Sign During EVAS Follow-up.
To report a heretofore undescribed complication seen on imaging after endovascular aortic sealing (EVAS).



A 77-year-old woman was treated with the Nellix EVAS device for an infrarenal aortic aneurysm. After a normal computed tomography (CT) scan at 15 days, the 6-month CT showed the onset of perianeurysmal inflammatory tissue. The patient was asymptomatic, and blood tests were normal. Imaging suggested a nonaggressive inflammatory process, so a conservative approach was adopted with close follow-up. The periaortic tissue remitted without any treatment after a further 9 months (16 months after EVAS).



The cause of this nonacute complication is unclear. Some clues suggest that interaction between the endobags and aneurysm wall could be involved. Imaging and clinical data led to a successful conservative strategy.
1 Department of Vascular Surgery, University of Brescia, Italy.
Stefano
S
Bonardelli
2 Department of Radiology, University of Brescia, Italy.
Marco
M
Ravanelli
1 Department of Vascular Surgery, University of Brescia, Italy.
Barbara
B
Paro
2 Department of Radiology, University of Brescia, Italy.
Giuseppe
G
Battaglia
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D011237:Predictive Value of Tests; D012185:Retroperitoneal Fibrosis / Q000000981:diagnostic imaging* / Q000209:etiology; D016896:Treatment Outcome
abdominal aortic aneurysm; computed tomography; endovascular aneurysm sealing; inflammation; magnetic resonance imaging; periaortic inflammatory reaction