The Progression of Billowing of Endologix AFX2® Abdominal Aortic Aneurysm Device as a Precursor for the Rupture of an Abdominal Aortic Aneurysm

Chang, Heepeel; Hadro, Neal C.; Norris, Marc A.; Rhee, Sang Won; Morris, Marvin E.

doi:10.1016/j.avsg.2018.06.019

Cited by 8 publications

(16 citation statements)

References 6 publications

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“…On the other hand, the outer AFX fabric exposed to aortic pulsations can weaken over time and develop a tear (IIIb) as reported in the present case 10 . Additionally, Billowing, an outward bulging of the external fabric beyond the metallic endoskeleton, typical Endologix AFX phenomenon, has been considered carefully as another etiology of type III endoleaks from these stent grafts 11 …”

Section: Discussionmentioning

confidence: 48%

“…10 Additionally, Billowing, an outward bulging of the external fabric beyond the metallic endoskeleton, typical Endologix AFX phenomenon, has been considered carefully as another etiology of type III endoleaks from these stent grafts. 11 Based on insufficient evidence and experiences, it is still debatable what the underlying mechanism of fabric defect of our case is. It is suggested that the mechanism of our case was explained under the hypotheses (i), (ii), and (iii).…”

Section: Case Reportmentioning

confidence: 89%

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Early‐onset persistent type IIIb endoleak following incraft stent graft implantation in an abdominal aortic aneurysm patient

Park

Rha

2022

Cathet Cardio Intervent

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The type IIIb endoleak a rare complication of endovascular aneurysmal repair caused by endoprosthesis problem leading to deteriorating rupture, which is one of the major reasons for lifelong imaging surveillance. We report a case of an early‐onset type IIIb endoleak from a tear in main body bifurcation (flow divider) area like crotch point tearing of pants following additional intervention to reduce immediate type Ia endoleak. Successful treatment of the endoleak was achieved by surgical conversion.

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Section: Discussionmentioning

confidence: 48%

Section: Case Reportmentioning

confidence: 89%

Early‐onset persistent type IIIb endoleak following incraft stent graft implantation in an abdominal aortic aneurysm patient

Park

Rha

2022

Cathet Cardio Intervent

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“…Although billowing is considered a benign finding, 7 recent reports have cast some doubt. 8,9 Billowing has been reported only for the Powerlink endograft so far, 7-10 and we believe that this is the first reported case of billowing in a patient with the Altura endograft. The lack of long-term data on this graft (median, 12.5 months) should be viewed as a limitation to its use.…”

Section: Discussionmentioning

confidence: 64%

A Unique Indication for the Altura Endograft to Repair Bilateral Common Iliac Artery Aneurysms Associated with a Short–Infrarenal Aorta

et al. 2020

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A 71-year-old man with end-stage renal disease on hemodialysis presented with bilateral common iliac artery aneurysms diagnosed during the workup of his chronic kidney disease. On computed tomography angiography, common iliac artery aneurysm diameters measured 6.1 cm on the right side and 3.1 cm on the left side. The infrarenal aorta also had a small 3.2-cm aneurysm, but the length from the lowest left renal to the aortic bifurcation was only 6.7 cm, precluding use of most bifurcated endografts. Following an uneventful staged preoperative internal iliac artery embolization, a two-piece D-shaped Altura endograft for the aorta, with bilateral iliac components, landing at the level of the external iliac arteries was successfully performed. Postoperative course was uneventful with no endoleak or endograft migration on computerized tomographic angiography 45 days later, although billowing mimicking an endoleak was evident and will be closely followed.

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“…On CT scan, the billowing phenomenon appears as a slightly hyperdense rim of density beyond the endoskeleton within the outer fabric material, with typical cauliflower-like shape [ 42 ]. On CT angiography, contrary to endoleak, in Endologix stent-graft, the intravenous contrast agent stays confined inside the curvilinear thin hyperdense line of the graft cover, without any connection to the excluded aneurysm sacs, and maintains the same curvilinear configuration as before the contrast [ 43 ]. Although billowing was firstly considered a benign condition, the progression of this phenomenon may cause a continued pressurization of the AAA sac with risk of rupture [ 42 ].…”

Section: Endograft Device-related Complicationsmentioning

confidence: 99%

CT angiography for the assessment of EVAR complications: a pictorial review

Gozzo¹,

Caruana

Cannella

et al. 2022

Insights Imaging

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Endovascular aneurysm repair (EVAR) is a minimally invasive treatment proposed as an alternative to open repair in patients with abdominal aortic aneurysms. EVAR consists in a stent-graft placement within the aorta in order to exclude the aneurysm from arterial circulation and reduce the risk of rupture. Knowledge of the various types of devices is mandatory because some stents/grafts are more frequently associated with complications. CT angiography is the gold standard diagnostic technique for preprocedural planning and postprocedural surveillance. EVAR needs long-term follow-up due to the high rate of complications. Complications can be divided in endograft device-related and systemic complications. The purpose of this article is to review the CT imaging findings of EVAR complications and the key features for the diagnosis.

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The Progression of Billowing of Endologix AFX2® Abdominal Aortic Aneurysm Device as a Precursor for the Rupture of an Abdominal Aortic Aneurysm

Cited by 8 publications

References 6 publications

Early‐onset persistent type IIIb endoleak following incraft stent graft implantation in an abdominal aortic aneurysm patient

Early‐onset persistent type IIIb endoleak following incraft stent graft implantation in an abdominal aortic aneurysm patient

A Unique Indication for the Altura Endograft to Repair Bilateral Common Iliac Artery Aneurysms Associated with a Short–Infrarenal Aorta

CT angiography for the assessment of EVAR complications: a pictorial review

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