Key result
Lumbar artery ligation and aneurysmorrhaphy successfully treated a rare late rupture of an abdominal aortic aneurysm caused solely by an isolated type II endoleak 11 years post-EVAR.
Why the study?
Rupture of abdominal aortic aneurysm due to an isolated type II endoleak is rarely reported, accounting for less than 1% of all type II endoleaks.
Case Report (n=1)
This case highlights that isolated type II endoleaks can rarely cause late AAA rupture after EVAR, necessitating surgical intervention.
Isolated TIIEL may cause late post-EVAR AAA rupture; hypothesis-generating for surveillance duration and thresholds.
Rupture of abdominal aortic aneurysm (AAA) due to an isolated type II endoleak (TIIEL) is rarely reported, accounting for less than 1% of all TIIELs; typically, rupture associated with TIIEL is accompanied by type I or type III endoleaks. We report a case of ruptured AAA secondary to TIIEL without any other types of endoleaks, occurring late after endovascular abdominal aortic repair (EVAR). A 77-year-old man with a history of EVAR 11 years earlier presented with abdominal pain. Computed tomography revealed a ruptured AAA, likely due to TIIEL from the lumbar artery. He was on warfarin for atrial fibrillation, and his preoperative PT-INR was 6.05. After administering lyophilized human prothrombin complex concentrate, lumbar artery ligation and aneurysmorrhaphy were performed. Intraoperatively, there was pulsatile bleeding from the lumbar artery, which was sutured closed. No other types of endoleaks were observed. The postoperative course was uneventful, and the patient was discharged home.
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Shimano et al. (2024) conducted a case report in Ruptured abdominal aortic aneurysm secondary to type II endoleak (n=1). Lumbar artery ligation and aneurysmorrhaphy was evaluated on Postoperative course and survival. Lumbar artery ligation and aneurysmorrhaphy successfully treated a rare late rupture of an abdominal aortic aneurysm caused solely by an isolated type II endoleak 11 years post-EVAR.
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