Fate of the excluded abdominal aortic aneurysm sac: Long-term follow-up of 831 patients

Abstract

Retroperitoneal exclusion and bypass is a viable alternative to traditional open endoaneurysmorraphy in surgery for abdominal aortic aneurysm. Most excluded aneurysm sacs have thrombosis without any long- or short-term complications; however, in a small number of patients delayed rupture of patent aneurysm occurs, thus emphasizing the need for diligent follow-up and appropriate intervention.

Leakages after Endovascular Repair of Aortic Aneurysms: Classification Based on Findings at CT, Angiography, and Radiography

“…The findings of Resnikoff et al (14) and our data indicate that CT is the single most sensitive method for detecting leakages. Although color Doppler ultrasonography (US) is a useful method for demonstrating leakages, its application is limited because a majority of patients with aortic leakages tend to be older and obese, and, thus, some segments of the infrarenal aorta may not be adequately depicted.…”

“…Resnikoff et al (14) examined 831 patients who underwent nonresective treatment of infrarenal abdominal aortic aneurysms by means of proximal and distal ligation of the aneurysmal sac combined with aortic bypass grafting, and reported only 17 (2%) retrograde leakages, which were supplied by the lumbar, hypogastric, or inferior mesenteric arteries. A high percentage of these patients had ruptures during the follow-up period.…”

A complication of open abdominal aortic aneurysm repair closely resembling a type II endoleak

“…4 However, endoleak following conventional "inlay" open aneurysm surgery is rare with only a few reports in the world literature. The first report was by Chan et al, with a series of six cases of type I endoleak (one proximal, five distal anastomotic leaks), which presented between 6 weeks and 18 months after surgery.…”

Exclusion of Lumbar Arteries by Aortic Endovascular Grafts: Can Angiography Demonstrate Sealing Characteristics?

“…However, the endovascular repair has to rely on thrombosis of these branches following thrombus form ation wit hin the aneurysm sac. The former aneurysm ligation technique demonstrated that this mechanism is likely to occur, but it did not preclude further aneurysm rupture in a few cases (7). The potential of lumbar arteries for subsequent thrombosis after occlusion of their orifices is not known.…”