Key result
Open repair using an interposition Dacron graft with felt pledgets and complete endograft preservation successfully treated a ruptured abdominal aortic aneurysm with type III endoleak, with the patient remaining asymptomatic at 2 years.
Why the study?
Abdominal aortic aneurysm rupture after EVAR is a significant limitation of endovascular technology, and endograft preservation during open conversion improves perioperative outcomes.
Case Report (n=1)
No
An interposition Dacron graft with felt pledgets is a viable bail-out option for open reconstruction of a type III endoleak with total endograft preservation in high-risk patients with ruptured AAA after EVAR.
May offer bail-out for type III endoleak with endograft preservation in high-risk patients; hypothesis-generating and needs prospective validation.
Abdominal aortic aneurysm rupture after endovascular aneurysm repair (EVAR) is rare, but remains a significant limitation of endovascular technology. Preservation of the endograft during open conversion of a post-EVAR rupture has been shown to be associated with improved perioperative outcomes. An interposition Dacron graft with felt pledgets is a novel bail-out option for the open reconstruction of a type III endoleak with total endograft preservation. This technique is useful in high-risk patients presenting with ruptured abdominal aortic aneurysm after EVAR and no clear source of endoleak.
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Bellamkonda et al. (2020) conducted a case report in Ruptured abdominal aortic aneurysm after EVAR (n=1). Open repair with interposition Dacron graft and endograft preservation was evaluated on Clinical outcome at follow-up. Open repair using an interposition Dacron graft with felt pledgets and complete endograft preservation successfully treated a ruptured abdominal aortic aneurysm with type III endoleak, with the patient remaining asymptomatic at 2 years.
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