Total realignment of multibranch stent graft using redo branch-in-branch endovascular repair for occult endoleak with rapid aneurysm sac expansion
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...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-09-01
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| Series: | Journal of Vascular Surgery Cases and Innovative Techniques |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468428720300691 |
| _version_ | 1819150447762472960 |
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| author | Aleem K. Mirza, MD Emanuel R. Tenorio, MD, PhD Thanila A. Macedo, MD Jussi M. Kärkkäinen, MD, PhD Swati Chaparala, MD Gustavo S. Oderich, MD |
| author_facet | Aleem K. Mirza, MD Emanuel R. Tenorio, MD, PhD Thanila A. Macedo, MD Jussi M. Kärkkäinen, MD, PhD Swati Chaparala, MD Gustavo S. Oderich, MD |
| author_sort | Aleem K. Mirza, MD |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-22T14:17:39Z |
| format | Article |
| id | doaj.art-604e034923c644d29c9855b2ee2e28c1 |
| institution | Directory Open Access Journal |
| issn | 2468-4287 |
| language | English |
| last_indexed | 2024-12-22T14:17:39Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Vascular Surgery Cases and Innovative Techniques |
| spelling | doaj.art-604e034923c644d29c9855b2ee2e28c12022-12-21T18:23:04ZengElsevierJournal of Vascular Surgery Cases and Innovative Techniques2468-42872020-09-0163392396Total realignment of multibranch stent graft using redo branch-in-branch endovascular repair for occult endoleak with rapid aneurysm sac expansionAleem K. Mirza, MD0Emanuel R. Tenorio, MD, PhD1Thanila A. Macedo, MD2Jussi M. Kärkkäinen, MD, PhD3Swati Chaparala, MD4Gustavo S. Oderich, MD5Advanced Endovascular Aortic Program, Aortic Center, Mayo Clinic, Rochester, MinnAdvanced Endovascular Aortic Program, Aortic Center, Mayo Clinic, Rochester, MinnAdvanced Endovascular Aortic Program, Aortic Center, Mayo Clinic, Rochester, MinnAdvanced Endovascular Aortic Program, Aortic Center, Mayo Clinic, Rochester, MinnAdvanced Endovascular Aortic Program, Aortic Center, Mayo Clinic, Rochester, MinnCorrespondence: Gustavo S. Oderich, MD, Gonda Vascular Center, Mayo Clinic, 200 1st St SW, Rochester, MN 55902; Advanced Endovascular Aortic Program, Aortic Center, Mayo Clinic, Rochester, MinnOccult 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.http://www.sciencedirect.com/science/article/pii/S2468428720300691Occult endoleakFenestrated and branched endovascular aortic repairPhysician-modified endovascular graftEndotensionType V endoleak |
| spellingShingle | Aleem K. Mirza, MD Emanuel R. Tenorio, MD, PhD Thanila A. Macedo, MD Jussi M. Kärkkäinen, MD, PhD Swati Chaparala, MD Gustavo S. Oderich, MD Total realignment of multibranch stent graft using redo branch-in-branch endovascular repair for occult endoleak with rapid aneurysm sac expansion Journal of Vascular Surgery Cases and Innovative Techniques Occult endoleak Fenestrated and branched endovascular aortic repair Physician-modified endovascular graft Endotension Type V endoleak |
| title | Total realignment of multibranch stent graft using redo branch-in-branch endovascular repair for occult endoleak with rapid aneurysm sac expansion |
| title_full | Total realignment of multibranch stent graft using redo branch-in-branch endovascular repair for occult endoleak with rapid aneurysm sac expansion |
| title_fullStr | Total realignment of multibranch stent graft using redo branch-in-branch endovascular repair for occult endoleak with rapid aneurysm sac expansion |
| title_full_unstemmed | Total realignment of multibranch stent graft using redo branch-in-branch endovascular repair for occult endoleak with rapid aneurysm sac expansion |
| title_short | Total realignment of multibranch stent graft using redo branch-in-branch endovascular repair for occult endoleak with rapid aneurysm sac expansion |
| title_sort | total realignment of multibranch stent graft using redo branch in branch endovascular repair for occult endoleak with rapid aneurysm sac expansion |
| topic | Occult endoleak Fenestrated and branched endovascular aortic repair Physician-modified endovascular graft Endotension Type V endoleak |
| url | http://www.sciencedirect.com/science/article/pii/S2468428720300691 |
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