Late Type 3b Endoleak Mimicking Type 2 Endoleak after Endovascular Aortic Aneurysm Repair

Abstract

Endovascular abdominal aortic aneurysm (AAA) repair has been widely used for the treatment of AAA as a safe and efficient method, but endoleaks causing persistent expansion of aneurysm sac may cause aneurysmal rupture and death. Type 3 endoleak is rare but a predominant cause of late rupture. Type 3b endoleak can be misdiagnosed as type 2 endoleak, which is more frequent. Here we report two cases of type 3b endoleak mimicking type 2 endoleak, which were successfully treated by open surgery of partial explantation of the stent-graft and endoaneurysmal interposition graft replacement.

Successful hybrid management of a ruptured abdominal aortic aneurysm induced by type II and IIIB endoleaks after endovascular aortic repair

“…A type III endoleaks can also be divided into two types; a type IIIA endoleak originates from disconnections in the endografts, whereas a type IIIB endoleak originates from a defect in the endograft. It can be tough to detect a type IIIB endoleak by angiography or CT angiography, and it can mimic a type II endoleak on CT angiography 7 . Similar to that in our case, it is often detected only during open surgery.…”

“…Similar to that in our case, it is often detected only during open surgery. Although it remains unclear whether a type IIIB endoleak can enlarge the aneurysm sac, the cause of the endoleak needs to be recognized when the type cannot be accurately identified 7 . Multiple approaches for the management of type IIIB endoleaks have been proposed 7, 8, 9.…”

“…Although it remains unclear whether a type IIIB endoleak can enlarge the aneurysm sac, the cause of the endoleak needs to be recognized when the type cannot be accurately identified 7 . Multiple approaches for the management of type IIIB endoleaks have been proposed 7, 8, 9. For instance, if the anatomic condition is amenable, an endovascular approach is less invasive than explantation of the endograft and graft replacement.…”

Combined graft surgery technique in the management of late endovascular aneurysm repair type III endoleak. A case report

“…This type of endoleak is less common than the other types. Patients with type III endoleak complication need surgical ıntervention which can be done by endovascular or open surgical approach [15]. In our case, the patient had low blood parameters and low blood pressure which were the cause to do urgent surgery.…”