Re-Do Endovascular Endoleak Embolization by Transprosthetic Puncture After Endovascular Aneurysm Repair

Abstract

Background: Compared with open repair of abdominal aortic aneurysms, endovascular aneurysm repair (EVAR) is less invasive and results in better perioperative outcomes and lower perioperative mortality risk. However, complications, such as endoleaks, can be frequent, leading to interventions on the stent graft. Managing endoleaks remains controversial. Case Summary: Type I endoleaks require secondary intervention because of a high rupture risk, whereas type II endoleaks are treated if the aneurysm sac grows. The most effective treatment for type II endoleaks is still debated. Transcatheter embolization, including the less-invasive transprosthetic puncture embolization, may offer a better alternative to open surgery. Review Summary: This review discusses type II endoleak management strategies, emphasizing transprosthetic puncture embolization, which provided excellent results in our case. Take-Home Messages: Transprosthetic puncture embolization is a safe, effective treatment for type II endoleaks post-EVAR. This case demonstrates its successful application with no complications at follow-up.

Keywords

• aneurysm
• aorta
• embolization
• endovascular repair
• peripheral