Open repair of a type II endoleak facilitated by temporary disconnection of graft components

Abstract

Endoleaks are a frequent indication for reintervention after endovascular repair of an abdominal aortic aneurysm. Here we present a method of open repair of a persistent type II endoleak involving graft component separation and reconstruction, in a patient with symptomatic interval aneurysmal sac enlargement despite endovascular coiling and embolization. This case report demonstrates an alternative open technique of endograft component separation and reconstruction that may be required in cases where open repair with sac exploration and vessel oversewing is hindered by the graft position.

Management of Persistent Perfusion of an Excluded Popliteal Artery Segment Following Penetrating Vascular Injury

“…While endovascular approaches to the culprit vessel are ideal in settings in which this capability is available, in austere or low-resource environments, open exploration might be necessary. Just as open-sac exploration is the proper solution for persistent type-II endoleaks following EVAR, if catheter-based techniques are either not available or have proven unsuccessful [9,10], then open exploration is the proper course in these resource-constrained environments.…”