Document Detail


Failed AAA endograft exclusion due to type II endoleak: explant analysis.
MedLine Citation:
PMID:  11491259     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To report the patient history and analysis of an explanted modular bifurcated endograft that was implanted to exclude an abdominal aortic aneurysm (AAA). CASE REPORT: An 80-year-old man with a 6-cm AAA underwent uneventful endovascular implantation of a bifurcated AneuRx stent-graft. His postprocedural clinical course was uneventful, although persistent contrast enhancement of the aneurysm remained via the inferior mesenteric artery (IMA). By 6 months, an endoleak connecting to the lumbar and mesenteric arteries became apparent. Over the ensuing 12 months, the endoleak and aneurysm enlarged; branch artery embolization was attempted in 4 percutaneous procedures. Despite successful IMA occlusion, the aneurysm continued to increase in diameter and volume, necessitating conversion to a conventional bypass at 20 months. Analysis of the explanted specimen revealed an intact endograft with fibrous incorporation of the stent framework at the proximal and distal fixation sites only; no incorporation of the endograft was noted within the aneurysm. The feeding channel for the endoleak was not identified. CONCLUSIONS: Serial imaging is a vital component of endograft surveillance, and persistent type II endoleaks that cannot be completely embolized endanger the longevity of the aneurysm exclusion. Explant analysis can play an important role in understanding the mechanisms of endograft failure.
Authors:
R A White; I Walot; C E Donayre; J Woody; G E Kopchok
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  8     ISSN:  1526-6028     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-08-08     Completed Date:  2001-12-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  254-61     Citation Subset:  IM    
Affiliation:
Department of Surgery, Harbor-UCLA Medical Center, Torrance, California 90509, USA. rawhite@ucla.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal / complications,  radiography,  surgery*
Equipment Failure Analysis
Humans
Male
Mesenteric Artery, Inferior / radiography,  transplantation
Postoperative Complications / etiology,  radiography
Prosthesis Implantation / contraindications
Stents
Tomography, X-Ray Computed
Transplants*
Treatment Failure
Vascular Surgical Procedures

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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