PURPOSE: To report the patient history and analysis of an explanted
modular bifurcated endograft that was implanted to exclude an abdominal
aortic aneurysm (AAA). CASE REPORT: An 80-year-old man with a 6-cm
AAA underwent uneventful endovascular implantation of a bifurcated
AneuRx stent-graft. His postprocedural clinical course was uneventful,
although persistent contrast enhancement of the aneurysm remained
via the inferior mesenteric artery (IMA). By 6 months, an endoleak
connecting to the lumbar and mesenteric arteries became apparent.
Over the ensuing 12 months, the endoleak and aneurysm enlarged; branch
artery embolization was attempted in 4 percutaneous procedures. Despite
successful IMA occlusion, the aneurysm continued to increase in diameter
and volume, necessitating conversion to a conventional bypass at
20 months. Analysis of the explanted specimen revealed an intact
endograft with fibrous incorporation of the stent framework at the
proximal and distal fixation sites only; no incorporation of the
endograft was noted within the aneurysm. The feeding channel for
the endoleak was not identified. CONCLUSIONS: Serial imaging is a
vital component of endograft surveillance, and persistent type II
endoleaks that cannot be completely embolized endanger the longevity
of the aneurysm exclusion. Explant analysis can play an important
role in understanding the mechanisms of endograft failure.
%0 Journal Article
%1 White2001
%A White, R. A.
%A Walot, I.
%A Donayre, C. E.
%A Woody, J.
%A Kopchok, G. E.
%D 2001
%J J Endovasc Ther
%K 80 Abdominal, Aged, Aged; Analysis; Aneurysm, Aortic Artery, Complications, Computed; Equipment Failure Failure; Humans; Implantation, Inferior, Male; Mesenteric Postoperative Procedures Prosthesis Stents; Surgical Tomography, Transplants; Treatment Vascular X-Ray and complications/radiography/surgery; contraindications; etiology/radiography; over; radiography/transplantation;
%N 3
%P 254--261
%T Failed AAA endograft exclusion due to type II endoleak: explant analysis.
%V 8
%X PURPOSE: To report the patient history and analysis of an explanted
modular bifurcated endograft that was implanted to exclude an abdominal
aortic aneurysm (AAA). CASE REPORT: An 80-year-old man with a 6-cm
AAA underwent uneventful endovascular implantation of a bifurcated
AneuRx stent-graft. His postprocedural clinical course was uneventful,
although persistent contrast enhancement of the aneurysm remained
via the inferior mesenteric artery (IMA). By 6 months, an endoleak
connecting to the lumbar and mesenteric arteries became apparent.
Over the ensuing 12 months, the endoleak and aneurysm enlarged; branch
artery embolization was attempted in 4 percutaneous procedures. Despite
successful IMA occlusion, the aneurysm continued to increase in diameter
and volume, necessitating conversion to a conventional bypass at
20 months. Analysis of the explanted specimen revealed an intact
endograft with fibrous incorporation of the stent framework at the
proximal and distal fixation sites only; no incorporation of the
endograft was noted within the aneurysm. The feeding channel for
the endoleak was not identified. CONCLUSIONS: Serial imaging is a
vital component of endograft surveillance, and persistent type II
endoleaks that cannot be completely embolized endanger the longevity
of the aneurysm exclusion. Explant analysis can play an important
role in understanding the mechanisms of endograft failure.
@article{White2001,
abstract = {PURPOSE: To report the patient history and analysis of an explanted
modular bifurcated endograft that was implanted to exclude an abdominal
aortic aneurysm (AAA). CASE REPORT: An 80-year-old man with a 6-cm
AAA underwent uneventful endovascular implantation of a bifurcated
AneuRx stent-graft. His postprocedural clinical course was uneventful,
although persistent contrast enhancement of the aneurysm remained
via the inferior mesenteric artery (IMA). By 6 months, an endoleak
connecting to the lumbar and mesenteric arteries became apparent.
Over the ensuing 12 months, the endoleak and aneurysm enlarged; branch
artery embolization was attempted in 4 percutaneous procedures. Despite
successful IMA occlusion, the aneurysm continued to increase in diameter
and volume, necessitating conversion to a conventional bypass at
20 months. Analysis of the explanted specimen revealed an intact
endograft with fibrous incorporation of the stent framework at the
proximal and distal fixation sites only; no incorporation of the
endograft was noted within the aneurysm. The feeding channel for
the endoleak was not identified. CONCLUSIONS: Serial imaging is a
vital component of endograft surveillance, and persistent type II
endoleaks that cannot be completely embolized endanger the longevity
of the aneurysm exclusion. Explant analysis can play an important
role in understanding the mechanisms of endograft failure.},
added-at = {2011-03-11T12:21:24.000+0100},
author = {White, R. A. and Walot, I. and Donayre, C. E. and Woody, J. and Kopchok, G. E.},
biburl = {https://www.bibsonomy.org/bibtex/250ec5e1c149a5f63594a2f09cd323376/jmaiora},
institution = {Department of Surgery, Harbor-UCLA Medical Center, Torrance, California
90509, USA. rawhite@ucla.edu},
interhash = {60ac4617252d14d33932506ce8692318},
intrahash = {50ec5e1c149a5f63594a2f09cd323376},
journal = {J Endovasc Ther},
keywords = {80 Abdominal, Aged, Aged; Analysis; Aneurysm, Aortic Artery, Complications, Computed; Equipment Failure Failure; Humans; Implantation, Inferior, Male; Mesenteric Postoperative Procedures Prosthesis Stents; Surgical Tomography, Transplants; Treatment Vascular X-Ray and complications/radiography/surgery; contraindications; etiology/radiography; over; radiography/transplantation;},
language = {eng},
medline-pst = {ppublish},
month = Jun,
number = 3,
owner = {Josu},
pages = {254--261},
pmid = {11491259},
timestamp = {2011-03-11T12:21:28.000+0100},
title = {Failed AAA endograft exclusion due to type II endoleak: explant analysis.},
volume = 8,
year = 2001
}