Aneurysmal degeneration and type Ib endoleak with proximal aneurysm rupture: A case report, review of literature and technical suggestions

Kordzadeh, Ali; Scott, H. William; Railton, Nicholas; Panayiotopoulos, Y.P.

doi:10.1016/j.amsu.2014.02.018

Cited by 5 publications

(4 citation statements)

References 19 publications

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“…Specific data on selected studies are reported in Table 1. [7][8][9][10][11][12][13][14][15][16][17] Patients and EVAR procedure Total number of included patients was 29. Patients' demographics are summarized in Table 1.…”

Section: Search Resultsmentioning

confidence: 99%

A systematic review of treatment modalities and outcomes of type Ib endoleak after endovascular abdominal aneurysm repair

et al. 2017

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Objectives To collect specific literature on type Ib endoleak after aorto-iliac endografting for abdominal aortic aneurysm, reporting data on diagnosis, treatment, and follow-up results. Methods Publications about type Ib endoleak after aorto-iliac endografting for abdominal aortic or iliac aneurysm were searched in PubMed, Web of Science, and Scopus. Considered studies were in English and published until 3 November 2016. Research methods and reporting were performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Inclusion criteria were: (1) reporting on abdominal aortic or iliac aneurysm as primary diagnosis; (2) reporting on distal endoleak after aorto-iliac endografting. Patient data, data on endovascular treatment, endoleak, reintervention, and follow-up were collected by two independent authors. Results Included studies were 11 (five original articles, six case reports), corresponding to 29 patients and 30 type Ib endoleak. Excluding missing data (2/30, 6.7%), type Ib endoleak was treated intra-operatively, within six months and after six months in six cases (21.4%), eight cases (28.6%), and fourteen cases (50%), respectively. Treatment of type Ib endoleak was endovascular in 27 cases (90%) (7 embolizations + extender cuffs, 10 extender cuffs, 8 embolizations without extender cuff, 1 Palmaz stenting and 1 iliac branched endograft), hybrid in 1 case (3.3%) and surgical in 2 cases (6.6%). Buttock claudication occurred in two cases (6.7%). One-month mortality was 3.4% (2/29) without events due to type Ib endoleak. In 14 cases (46.7%), median follow-up was six months (interquartile range: 2.75-14; range: 0.75-53). Type Ib endoleak persisted or reappeared in three cases (10%), all after endovascular treatment. Two of these (2/3, 66.7%) needed endovascular reintervention. No death during follow-up was reported. Conclusions Few specific data are available in literature about type Ib endoleak after aorto-iliac endografting for abdominal aortic aneurysm. About 50% of type Ib endoleak occurred after six months from the endovascular abdominal aneurysm repair procedure. Treatment is mainly endovascular and distal endograft extension is the main and effective treatment. Buttock claudication is the most frequent complication in case of exclusion of internal iliac artery. Persistent type Ib endoleak is possible, and adjunctive endovascular procedures are necessary.

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Section: Search Resultsmentioning

confidence: 99%

A systematic review of treatment modalities and outcomes of type Ib endoleak after endovascular abdominal aneurysm repair

et al. 2017

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“…This is reflected in the lack of cross-clamping (short neck suprarenal and supraceliac), lack of ischemic time or long operative period, and, in worse-case scenarios, EVAR explantation. 9 , 10 ) Furthermore, the introduction of the new novel intraoperative assessment technique can maximize the benefits of the procedure by diminishing radiation exposure and/or contrast use.…”

Section: Discussionmentioning

confidence: 99%

Abdominal Aortic Neck Wrap for Refractory Type 1a Endoleak: A Case Series and a Novel Intraoperative Assessment Technique

Kordzadeh

Sayed

Ramirez

et al. 2021

Annals of Vascular Diseases

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Objective: Refractory type 1a endoleak after endovascular aneurysm repair (EVAR) can pose a significant challenge to surgeons and interventional radiologists. Continuous sac expansion results in aneurysm rupture and mortality. In such circumstances, an external infrarenal aortic wrap could serve as an essential and alternative solution. Methods: We assessed the application of an infrarenal aortic neck wrap for the treatment of refractory type 1a endoleak in n=6 consecutive patients along with the introduction of a novel assessment technique in order to assure their intraoperative success with no radiation exposure and contrast use. Results: The median sac expansion was 8.5 mm (interquartile range [IQR], 5-20 mm). The median neck diameter and length of the aortic neck were 23 mm (IQR, 18-25 mm) and 21 mm (IQR, 18-25 mm), respectively. The median length of follow-up post wrap is 24 months (IQR, 14-34 months). There was no associated mortality or morbidity and requirement for any further interventions. Conclusion: The study demonstrates that aortic wrapping for the treatment of refractory type 1a endoleak for any given neck diameter and length is safe, effective, and long lasting. The suggested novel intraoperative assessment technique contributes to the safety of the procedure by diminishing the need for intraoperative radiation exposure, contrast, and shorter operative time.

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“…Crucial for a favorable outcome and especially for the recovery of renal function is the drainage of the abdominal cavity and retroperitoneum (7,9).…”

Section: Discussionmentioning

confidence: 99%

Huge ruptured aneurysm of the abdominal aorta

Petrov

Panayotov

Ivanov

2015

SSM

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Ruptured aneurysms of the abdominal aorta are the greatest challenge in modern vascular surgery. The emergency of the situation, comorbidities, variations in the anatomy of the abdominal organs due to the large amount of blood in the abdomen in the development of AAA, as well as difficulties caused by the surgical access coupled with damage to the cardiovascular and urinary systems result in mortality rate of about 50% as reported by various authors. Open surgery in this scenario is superior to endovascular treatment EVAR (endovascular aneurysm repair) with prosthetic graft, since the latter does not provide adequate options to drain the retroperitoneal space, which is associated with a higher mortality rate. A clinical case is presented of a patient admitted and operated on 24.06.2013 in "St. Marina" Hospital in Varna with Dg. Ruptured Aneurysm of the abdominal aorta with hemorrhagic shock. Keywords: aneurysm of the abdominal aorta, rupture, bispinal incisionA clinical case is presented, D.D.D., 58., admitted on 06.24.2013 at ER of University Hospital "St. Marina" in Varna with ruptured aneurysm of the abdominal aorta and hemorrhagic shock.Patient history, clinical and imaging data were enough leads to the diagnosis ruptured aneurysm of the abdominal aorta, which had been developing for several hours prior to hospitalization. The patient was in shock, unresponsive and inadequate. No abnormal signs from the respiratory system. Blood pressure 60/20, HR -140/min. On palpation the abdominal wall appeared soft, slightly painful, with a large mass around the navel, pulsating synchronously with the heartbeat. Auscultation showed physiological peristalsis. Succusio renalis -negative on both sides. No spontaneous diuresis.The angiological examination found pulsations on the palpation sites of femoral arteries bilaterally, in a significantly larger area on the left side (due to aneurysm of the left femoral artery) and no distal pulsations, resulting of the low blood pressure and centralization of blood circulation, with purple skin spots, acrocianosis and cold extremities.RADIOLOGIC STUDIES CT scans of the chest and abdomen showed no pleural and pericardial effusions. No pathological signs in the lung parenchyma bilaterally. Small reticular hypoventilation areas and parenchymal thickenings bilaterally in the dorso-basal aspect. Aortopulmonary window lymph nodes up to 23/10mm, subcranial LN -18/9mm (Fig. 1).Dimensions of the aortic intraluminal diameters as measured in 3D reconstructions:

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Aneurysmal degeneration and type Ib endoleak with proximal aneurysm rupture: A case report, review of literature and technical suggestions

Cited by 5 publications

References 19 publications

A systematic review of treatment modalities and outcomes of type Ib endoleak after endovascular abdominal aneurysm repair

A systematic review of treatment modalities and outcomes of type Ib endoleak after endovascular abdominal aneurysm repair

Abdominal Aortic Neck Wrap for Refractory Type 1a Endoleak: A Case Series and a Novel Intraoperative Assessment Technique

Huge ruptured aneurysm of the abdominal aorta

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