Novel approach to a type I endoleak following a hybrid repair of an arch aortic aneurysm.

Published

Journal Article

Hybrid surgical and endovascular approaches such as open visceral vessel debranching and subsequent endovascular exclusion of thoracic abdominal aortic aneurysms (TAAA) represents a significant development in treatment of TAAAs. As compared to traditional endovascular aneurysm repair, hybrid repairs commonly have a higher rate of endoleak and other endograft-related complications. In this report, we present a 71 year-old man with significant comorbidities including chronic obstructive pulmonary disease, hypertension and prostate cancer. The patient after undergoing debranching of the thoracic arch followed by endograft repair of an arch aneurysm developed a proximal type I and type II endoleak fed by the previously ligated left subclavian artery. Despite coiling of the left subclavian artery and proximal extension of the endograft, a type I endoleak persisted. Several months after the left subclavian artery was coiled, a catheter was advanced through the coils and beyond the site of ligation directly into the aneurysmal sac. Once in the aneurysmal sac, multiple coils were deployed resulting in successful treatment of the type I endoleak. This report highlights the unique challenges in treating proximal descending thoracic aneurysms and represents the first report of the treatment of a type I endoleak with reaccess through a previously coiled vessel for deployment of embolics directly into the aneurysmal sac.

Full Text

Duke Authors

Cited Authors

  • Barnett, BP; Qazi, U; Perler, BA; Malas, MB

Published Date

  • August 2009

Published In

Volume / Issue

  • 43 / 4

Start / End Page

  • 389 - 392

PubMed ID

  • 19628521

Pubmed Central ID

  • 19628521

International Standard Serial Number (ISSN)

  • 1538-5744

Digital Object Identifier (DOI)

  • 10.1177/1538574409338329

Language

  • eng

Conference Location

  • United States