Download PDF
CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2018; 02(01): 055-058
DOI: 10.1055/s-0038-1641677
Case Report
Thieme Medical and Scientific Publishers Private Ltd.

Onyx Embolization of an Acute Type II Endoleak Causing Recurrent Hemorrhage Post Emergency Endovascular Aortic Aneurysm Repair for Ruptured Abdominal Aortic Aneurysm

Justin Pugh
1   Department of Interventional Radiology, University Hospitals of North Midlands, Staffordshire, United Kingdom
,
John R. Asquith
1   Department of Interventional Radiology, University Hospitals of North Midlands, Staffordshire, United Kingdom
,
Shuvro H. Roy Choudhury
1   Department of Interventional Radiology, University Hospitals of North Midlands, Staffordshire, United Kingdom
,
Richard Morgan
2   Department of Vascular Surgery, University Hospitals of North Midlands, Staffordshire, United Kingdom
,
David R. Wells
1   Department of Interventional Radiology, University Hospitals of North Midlands, Staffordshire, United Kingdom
› Author Affiliations
Further Information

Publication History

Received: 09 June 2017

Accepted: 27 September 2017

Publication Date:
03 May 2018 (online)

   Permissions and Reprints

Abstract

The authors report a case of ongoing retroperitoneal hemorrhage from a ruptured abdominal aortic aneurysm (AAA) following treatment by endovascular abdominal aortic aneurysm repair (EVAR). Unusually, the continued hemorrhage was secondary to a lumbar type II endoleak. This was successfully embolized with onyx. Only one other similar case has been reported.

Keywords

abdominal aortic aneurysm - acute type ii endoleak - endovascular repair
 

  • References

  • 1 Karthikesalingam A, Holt PJ, Vidal-Diez A. et al. Mortality from ruptured abdominal aortic aneurysms: clinical lessons from a comparison of outcomes in England and the USA. Lancet 2014; 383 9921 963-969
    CrossrefPubMedGoogle Scholar
  • 2 Powell JT, Sweeting MJ, Thompson MM. et al; IMPROVE Trial Investigators. Endovascular or open repair strategy for ruptured abdominal aortic aneurysm: 30 day outcomes from IMPROVE randomised trial. BMJ 2014; 348: f7661
    CrossrefPubMedGoogle Scholar
  • 3 Grieve R, Gomes M, Sweeting MJ. et al; IMPROVE Trial Investigators. Endovascular strategy or open repair for ruptured abdominal aortic aneurysm: one-year outcomes from the IMPROVE randomized trial. Eur Heart J 2015; 36 (31) 2061-2069
    CrossrefPubMedGoogle Scholar
  • 4 Brown A, Saggu GK, Bown MJ, Sayers RD, Sidloff DA. Type II endoleaks: challenges and solutions. Vasc Health Risk Manag 2016; 12: 53-63
    PubMedGoogle Scholar
  • 5 Kaczynski J, Jaber B, Woolgar J. Rupture of the infrarenal abdominal aortic aneurysm (AAA) following an endovascular aneurysm repair (EVAR) due to an isolated type II endoleak. BMJ Case Rep 2014; 2014 (14) bcr2013202964
    CrossrefPubMedGoogle Scholar
  • 6 Chan KK, Siu WT, Fung KH, Yau KK, Wong SK, Li MK. Acute symptomatic abdominal aortic aneurysm secondary to endovascular stent graft associated type II endoleak. Asian J Surg 2006; 29 (03) 157-160
    CrossrefPubMedGoogle Scholar
  • 7 Khaja MS, Park AW, Swee W. et al. Treatment of type II endoleak using onyx with long-term imaging follow-up. Cardiovasc Intervent Radiol 2014; 37 (03) 613-622
    CrossrefPubMedGoogle Scholar
  • 8 Saqib NU, Charlton-Ouw KM, Azizzadeh A. Managing type II endoleaks. Endovasc Today 2013; 45-50
    PubMedGoogle Scholar
  • 9 Chung R, Morgan RA. Type 2 endoleaks post-EVAR: current evidence for rupture risk, intervention and outcomes of treatment. Cardiovasc Intervent Radiol 2015; 38 (03) 507-522
    CrossrefPubMedGoogle Scholar
  • 10 Hartung O, Vidal V, Marani I, Saran A, Bartoli JM, Alimi YS. Treatment of an early type II endoleak causing hemorrhage after endovascular aneurysm repair for ruptured abdominal aortic aneurysm. J Vasc Surg 2007; 45 (05) 1062-1065
    CrossrefPubMedGoogle Scholar