Case report of type IIIa endoleak after endovascular aortic repair

Abstract

An 81-year-old male presented to our emergency department for abdominal pain and distension. The patient had previously undergone endovascular aortic repair (EVAR) procedure 9 years ago for infrarenal abdominal aortic aneurysm with regular follow-up in postoperative. Three years ago, computed tomography angiography (CT) revealed Type Ib endoleak with right common iliac artery expansion and Type II endoleak from inferior mesenteric artery (IMA). Then, the patient was successfully treated by relining the iliac stent-graft to cover the common iliac expansion and coil embolism to occlude IMA through the Riolan's arch using endovascular technique. Recently, the following up CTA displayed a new Type IIIa endoleak, which the left iliac limb was disconnected with the main body graft. The patient was ultimately successful to treat by implanting stent-grafts using endovascular therapy. This case emphasizes the necessity of follow-up examination for lifelong stent-grafts surveillance. We debated the current late-related complication of EVAR and stent-graft migration treatment choices.

Keywords

• abdominal aortic aneurysm
• endovascular aortic repair
• type iiia endoleak