Treatment of Type III Endoleak with an Aortouniiliac Stent Graft |
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Authors: | Theodore H. Teruya Juan Ayerdi Maurice M. Solis Ahmed M. Abou-Zamzam Jeffrey L. Ballard Robert B. McLafferty Kim J. Hodgson |
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Affiliation: | (1) Division of Vascular Surgery, Loma Linda University Medical Center, Loma Linda, CA, US;(2) Division of Peripheral Vascular Surgery, Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL, US |
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Abstract: | The purpose of this study was to present a novel treatment method for repair of a type III endoleak due to separation of modular components of an AneuRx (Medtronic AVE, Sunnyvalle, CA) stent graft as a result of graft kinking. A 73-year-old male had undergone endovascular repair of a 8.2-cm abdominal aortic aneurysm (AAA) 2 years previously. An aortic extender cuff was required to secure the proximal graft. Computed tomographic (CT) follow-up revealed a type III endoleak at 6-month follow-up. Plain radiographs showed separation between the main graft body and the aortic extender cuff. A second custom-made 28 mm × 5.5cm aortic extender cuff was placed to seal the type III endoleak. Follow-up CT showed a persistent endoleak with an increase in AAA size to 10.5 cm. The patient underwent remedial AAA repair with an aortouniiliac endograft placed within the previous stent graft and a femorofemoral bypass. At 3-month follow-up there was no detectable endoleak. This constitutes an alternative endovascular therapy for modular device separation (type-III endoleak) after endoluminal AAA repair in patients who cannot undergo repair with a second bifurcated graft. |
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