Total realignment of multibranch stent graft using redo branch-in-branch endovascular repair for occult endoleak with rapid aneurysm sac expansion.

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ID: 109327
2020
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Abstract
Occult endoleaks can pose a diagnostic and treatment challenge. These endoleaks are not effectively identified by multiphase computed tomography angiography, magnetic resonance angiography, or contrast-enhanced ultrasound. Possible causes are small fabric tears and slow-flow, dynamic, or positional endoleaks. We describe a patient with rapid aneurysm sac expansion and disseminated intravascular coagulopathy 46 months after four-vessel branched physician-modified endograft repair of a ruptured extent III thoracoabdominal aneurysm. Imaging failed to demonstrate an endoleak but identified fresh blood products within the sac. The patient underwent total realignment using branch-in-branch repair with a physician-modified endograft. Repeated imaging 25 days postoperatively revealed decrease in aneurysm diameter by 10 mm.
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Authors Mirza, Aleem K;Tenorio, Emanuel R;Macedo, Thanila A;Kärkkäinen, Jussi M;Chaparala, Swati;Oderich, Gustavo S;
Journal journal of vascular surgery cases and innovative techniques
Year 2020
DOI
10.1016/j.jvscit.2020.05.005
URL
Keywords
endotension fenestrated and branched endovascular aortic repair occult endoleak physician-modified endovascular graft type v endoleak

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