Massive Late Endoleak Type Ia, Associated With Shock and Acute Anemia: Conservative Surgical Treatment

We present a case of type 1 endoleaks associated with massive hemorrhage and shock, treated with traditional open surgery. We present a 74-year-old male patient with a history of endovascular repair of abdominal aortic aneurysm 6 years ago, was admitted to the emergency department in shock and acute anemia, showing a type IA endoleak associated with retroperitoneal hematoma. Open repair was performed with the interposition of a Dacron™ prosthesis with preservation of the aortic endoprosthesis. Although in these cases of extreme urgency, it has been proposed the extraction of the endoprosthesis, which involves a procedure associated with high mortality, in this case, it was feasible a simple repair as was the interposition of prosthesis between proximal aorta and endoprosthesis. Endovascular repair of aortic aneurysm requires strict monitoring and a good selection of patients for this procedure since this late complication has a high mortality rate.