Open Access
CC BY 4.0 · Aorta (Stamford) 2022; 10(S 01): A1-A56
DOI: 10.1055/s-0042-1750934
Presentation Abstracts

Type IA Endoleak Caused by Kissing Struts

Pauline Gaillard
1   Universite Libre de Bruxelles, Bruxelles, Belgium
,
Liesbeth Lootens
2   Clinique Ste-Anne/St-Remi, Bruxelles, Belgium
3   Clinique de la Basilique, Bruxelles, Belgium
,
Jane Nardella
2   Clinique Ste-Anne/St-Remi, Bruxelles, Belgium
,
Yann De Bast
2   Clinique Ste-Anne/St-Remi, Bruxelles, Belgium
3   Clinique de la Basilique, Bruxelles, Belgium
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    Introduction: Report a case about misdeployment of the suprarenal stent during endovascular abdominal aortic aneurysm repair (EVAR).

    Problem definition: A 67-year-old man was diagnosed with an asymptomatic abdominal aortic aneurysm measuring 42 mm in March 2019. During follow-up, echography showed an increase in diameters from 47 in 2020 to 56 mm in 2021. Elective repair with an EVAR procedure using a Zenith Alpha Abdominal endograft from Cook Medical was planned in January 2022.

    Results: The surgery went well besides a difficulty to have a beautiful 360 degree rotation of the pig tail after catheterization of the contralateral limb. At three days post-surgery an angioscan revealed a type-I endoleak to the left of the endoprosthesis. Postoperative course was uneventful. At one month a second follow-up angioscan confirmed type IA endoleak that was less important than the first time with a stable diameter of the aneurysm. Reconstruction showed that there was an incomplete deployment with two suprarenal stent struts who were left hanging together (kissing struts) . Type IA endoleak occurs in 10% of cases after an EVAR but a case of misdeployment has never been reported and is unknown to Cook Medical. Currently the patient is awaiting re-intervention and the medical team is seeking the best approach to treat him.

    Conclusion: This case report describes a rare complication of abdominal aortic aneurysm treatment by endovascular graft that has not been reported in the literature previously. This raises the question on how to spot these misdeployments more easily and how to treat them correctly.

    Zoom
    Fig. 1 Kissing Struts. Angioscan of endograft misdeployment.

    References

    1. Andrew C. Picel, Nikhil Kansal, Essentials of Endovascular Abdominal Aortic Aneurysm Repair Imaging: Postprocedure Surveillance and Complications. Vascular and Interventional Radiology Review, Department of Radiology, University of California San Diego. 2014 – PubMed

    2. Tamer W. Kassem, Follow up CT angiography post EVAR: Endoleaks detection, classification and management lanning. The Egyptian Journal of Radiology and Nuclear Medecine, Radiology Department, Cairo University, Egypt. 2017 – ScienceDirect.


     

    Die Autoren geben an, dass kein Interessenkonflikt besteht.

    Publikationsverlauf

    Artikel online veröffentlicht:
    10. Juni 2022

    © 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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    Zoom
    Fig. 1 Kissing Struts. Angioscan of endograft misdeployment.