Key result
An untreated type II endoleak following AneuRx aortic stent-graft deployment led to progressive aneurysm enlargement and fatal rupture at 24 months in an 81-year-old man.
Case Report (n=1)
Type II endoleaks following endovascular AAA repair can lead to progressive aneurysm enlargement and fatal rupture, highlighting the importance of surveillance and intervention.
Fatal rupture from untreated type II endoleak after EVAR warrants surveillance caution; leaves open optimal intervention thresholds.
PURPOSE: To describe the predictability of an abdominal aortic aneurysm (AAA) rupture secondary to a type II endoleak following stent-graft exclusion. METHODS AND RESULTS: An 81-year-old man with an enlarging AAA underwent endovascular repair using an AneuRx aortic stent-graft, but a type II endoleak fed by an accessory renal artery was detected at postprocedural computed tomography (CT). Surveillance CT scans at 6 and 16 months showed an increase in the aneurysm diameter and endoleak volume, but the patient refused advised treatment to close the leak. He suffered a fatal aneurysm rupture 24 months after endografting. Retrospective analysis of CT data documented progressive aneurysm enlargement that correctly predicted the rupture. CONCLUSIONS: Type II endoleaks can lead to aneurysm rupture. Three-dimensional (3D) spiral CT angiography offers an opportunity to track endoleak volume and the effect of exposure to systemic pressure on the aneurysm sac.
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White et al. (2000) conducted a case report in Abdominal aortic aneurysm with type II endoleak (n=1). AneuRx aortic stent-graft was evaluated on Aneurysm rupture. An untreated type II endoleak following AneuRx aortic stent-graft deployment led to progressive aneurysm enlargement and fatal rupture at 24 months in an 81-year-old man.
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