Rescue of a Failing Endovascular Infrarenal Aortic Repair Using an Off-The-Shelf Branched Endograft

Ann Vasc Surg. 2017 Nov:45:269.e15-269.e18. doi: 10.1016/j.avsg.2017.07.016. Epub 2017 Jul 21.

Abstract

Background: Proximal aortic dilation following open and endovascular aortic repair (EVAR) is a well-known phenomenon. If severe enough, it may lead to late onset of type Ia endoleak that jeopardizes the proximal seal.

Methods: We report the case of a patient previously treated by EVAR for an infrarenal aneurysm who developed a type Ia endoleak after proximal aortic dilation. His aneurysms enlarged to 10 cm mandating a rapid repair without the delay for a custom-made device.

Results: We successfully used the off-the-shelf thoracic t-Branch graft (Cook, Bloomington, IN) with its 4 branches to treat the dilated aorta and seal the endoleak.

Conclusion: The off-the-shelf t-Branch is a useful option in patient with previous EVAR presenting with proximal aortic dilation and endoleak who cannot wait for a custom-made device.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortography / methods
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis Implantation / methods
  • Blood Vessel Prosthesis*
  • Computed Tomography Angiography
  • Endoleak / diagnostic imaging
  • Endoleak / etiology
  • Endoleak / surgery*
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Humans
  • Male
  • Prosthesis Design
  • Reoperation
  • Salvage Therapy
  • Treatment Failure
  • Treatment Outcome