Successful Aortic Banding for Type IA Endoleak Due to Neck Dilatation after Endovascular Abdominal Aortic Aneurysm Repair: Case Report

Abstract

A 69-year-old man with a type IA endoleak that developed approximately 21 months after endovascular abdominal aortic aneurysm repair (EVAR) of a 46 mm diameter aneurysm was referred to our department. He had impaired renal function, Parkinson’s disease, and previous cerebral infarction. Computed tomography angiography showed a type IA endoleak with neck dilatation and that the aneurysm had grown to 60 mm in diameter. We decided to perform aortic banding. The type IA endoleak disappeared after banding and the patient was discharged on postoperative day 10. Aortic banding may be effective for type IA endoleak after EVAR and less invasive for high-risk patients in particular.

Partial open conversion with proximal aortic banding and endograft preservation is a safe option for the treatment of persistent type II endoleaks

“…Oversewing the felt pledget in place and suture fixing it to the graft stabilizes the proximal landing zone and prevents further complications, such as device migration or type 1A endoleak. 1,14,15 Precise placement of the band is necessary to avoid aortic stenosis and surgeons J o u r n a l P r e -p r o o f must also consider thrombus present in the aneurysm sac to prevent its displacement into the renal arteries. 13 Limitations to our study include small sample size and unequally sized groups.…”

“…Secondary banding secures and stabilizes the endograft in the landing zone after EVAR and is most commonly used to treat type IA endoleaks. 14,15 Since manipulation of the landing zone and treatment of type II endoleaks are debated in the literature, the objective of this study was to describe our technique of OPC with proximal aortic banding for the J o u r n a l P r e -p r o o f treatment of persistent type II endoleaks. We contrasted this technique with endograft explant to evaluate the potential benefits of OPC with aortic banding.…”

Novel open technique for repair of endograft migration

“…Limited or partial graft explantation results in reduced clamp time and is thought to reduce the complication rate 9 . Complete preservation of the endograft with reinforcement of the neck to achieve proximal seal has also been described to treat type IA endoleak, 10 although in our experience the long-term success of this technique is limited, and this is not an option with migrated and kinked graft.…”

Experience in Treatment of Patients with First Type Secondary Endoleaks

“…Оценка определения частоты встречаемости ЭЛ первого типа сложна, что обусловлено неоднородностью публикуемого материала и отсутствия единого регистра учета осложнений после ЭПА . Основными факторами риска (ФР) развития ЭЛ первого типа являются: неадекватный «оверсайзинг», значительная ангуляция шейки аневризмы, кальциноз шейки АБА, короткая шейка АБА, коническая форма АБА, циркулярная локализация тромба в области шейки и имплантации эндографта [17][18][19], наличие эндолика II типа и ряд других [17][18][19][20][21] .…”

“…ЭЛ Ib типа наиболее часто возникает при дилатированных, кальцифицированных коротких подвздошных артериях, их значительных изгибах, короткой ножке подвздошной части графта или ее миграции [8,11] . В большинстве случаев устранение ЭЛ Ib типа выполняют путем дистального удлинения графта [20], эмболизации внутренней подвздошной артерии или имплантации браншированного илиакального графта, что продемонстрированно и в одном нашем наблюдении с хорошим отдаленным результатом .…”