This case emphasizes the necessity of lifelong stent-graft surveillance and follow-up examinations after EVAR to detect and treat late-related complications such as endoleaks.
Emphasizes need for lifelong EVAR surveillance; leaves open optimal strategies for late Type Ib/II endoleaks.
An 81-year-old male presented to our emergency department for abdominal pain and distension. The patient had previously undergone endovascular aortic repair (EVAR) procedure 9 years ago for infrarenal abdominal aortic aneurysm with regular follow-up in postoperative. Three years ago, computed tomography angiography (CT) revealed Type Ib endoleak with right common iliac artery expansion and Type II endoleak from inferior mesenteric artery (IMA). Then, the patient was successfully treated by relining the iliac stent-graft to cover the common iliac expansion and coil embolism to occlude IMA through the Riolan's arch using endovascular technique. Recently, the following up CTA displayed a new Type IIIa endoleak, which the left iliac limb was disconnected with the main body graft. The patient was ultimately successful to treat by implanting stent-grafts using endovascular therapy. This case emphasizes the necessity of follow-up examination for lifelong stent-grafts surveillance. We debated the current late-related complication of EVAR and stent-graft migration treatment choices.
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Han et al. (2022) studied this question.
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