Trans-limb embolization for treatment of Type 2 endoleak post EVAR: Case report

Type 2 endoleaks (T2EL) occur after 10%–25% of endovascular abdominal aortic aneurysm repairs and increase the risk factor of endograft repair failure and rupture. Herein we report a case of endovascular treatment of T2EL where we performed a trans-limb embolization. A 63-years-old male previously t...

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Bibliographic Details
Published in:International journal of surgery case reports 2021-08, Vol.85, p.106238-106238, Article 106238
Main Authors: Dinoto, E., Ferlito, F., Urso, F., Evola, S., Bajardi, G., Pecoraro, F.
Format: Article
Language:English
Subjects:
Aneurysm
Case Report
Coil embolization
Endoleak type 2
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Summary:Type 2 endoleaks (T2EL) occur after 10%–25% of endovascular abdominal aortic aneurysm repairs and increase the risk factor of endograft repair failure and rupture. Herein we report a case of endovascular treatment of T2EL where we performed a trans-limb embolization. A 63-years-old male previously treated for AAA with endovascular aortic aneurysms repair (EVAR), showed an angio-CT scan followup with a type 2 endoleak fed from inferior mesenteric artery (AMI) with growth of AAA greater of 1 cm than preoperative CT-scan and increase of chronic lumbar pain. Due to high risk of rupture was performed a trans-limb embolization with complete sealing. The 6 months CT-angiography showed complete type 2 endoleak exclusion without changes of AAA. The risk of aneurysm rupture in the presence of an isolated T2EL is exceptionally low. However, when a persistent T2EL is associated with a significant sac size increase, commonly considered as at least 5 mm over 6 months, should be treated. Detachable coils are repositionable, allowing an extremely precise deployment and subsequent embolization of different targets. In this experience trans-limb embolization was feasible and this tool should be taken in account especially when no other surgical options exists. •Type 2 endoleaks (T2EL) are a risk factor for endograft repair failure and rupture.•T2EL are the most common endoleaks and remain the main cause of repeat intervention.•Trans-limb embolization is an innovative technique for T2EL without standard access.•Concerto are detachable coils repositionable allowing an extreme precise deployment.
ISSN:2210-2612
2210-2612
DOI:10.1016/j.ijscr.2021.106238