Abstract
Occult endoleaks can pose a diagnostic and treatment challenge. These endoleaks are not effectively identified by multiphase computed tomography angiography, magnetic resonance angiography, or contrast-enhanced ultrasound. Possible causes are small fabric tears and slow-flow, dynamic, or positional endoleaks. We describe a patient with rapid aneurysm sac expansion and disseminated intravascular coagulopathy 46 months after four-vessel branched physician-modified endograft repair of a ruptured extent III thoracoabdominal aneurysm. Imaging failed to demonstrate an endoleak but identified fresh blood products within the sac. The patient underwent total realignment using branch-in-branch repair with a physician-modified endograft. Repeated imaging 25 days postoperatively revealed decrease in aneurysm diameter by 10 mm.
Original language | English (US) |
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Pages (from-to) | 392-396 |
Number of pages | 5 |
Journal | Journal of Vascular Surgery Cases and Innovative Techniques |
Volume | 6 |
Issue number | 3 |
DOIs | |
State | Published - Sep 2020 |
Keywords
- Endotension
- Fenestrated and branched endovascular aortic repair
- Occult endoleak
- Physician-modified endovascular graft
- Type V endoleak
ASJC Scopus subject areas
- Surgery
- Cardiology and Cardiovascular Medicine