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Diagnosis and relining techniques for delayed type IIIB endoleaks with the second- generation AFX endograft  Gary Lemmon, MD, Andrew Barleben, MD, Peter.

Published byRudolf Rogers Modified over 5 years ago

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Presentation on theme: "Diagnosis and relining techniques for delayed type IIIB endoleaks with the second- generation AFX endograft  Gary Lemmon, MD, Andrew Barleben, MD, Peter."— Presentation transcript:

1 Diagnosis and relining techniques for delayed type IIIB endoleaks with the second- generation AFX endograft  Gary Lemmon, MD, Andrew Barleben, MD, Peter Nelson, MD, MS, H. Edward Garrett, MD  Journal of Vascular Surgery Cases and Innovative Techniques  Volume 5, Issue 1, Pages (March 2019) DOI: /j.jvscit Copyright © Terms and Conditions

2 Fig 1 Patient 1: A, Twelve-month computed tomography (CT) scan revealed new stent deformation and contrast within the aneurysm sac consistent with type IIIB endoleak despite decreasing sac size (arrows pointing to the endoleak). B, Intraoperative imaging with provoked angiogram (injection of contrast agent above both balloon-occluded iliac limbs to verify the endoleak) demonstrating type IIIB endoleak and absence of type IA endoleak. C, Completion angiogram after Palmaz stent and cuff placement (initial type IIIB treatment). D, Twelve-month CT scan after an initial type IIIB endoleak relining shows a new type IIIB endoleak, after two scans showing no endoleak. E, Completion angiogram after redo endovascular aneurysm repair (EVAR) with a Trivascular Ovation graft. Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, 51-53DOI: ( /j.jvscit ) Copyright © Terms and Conditions

3 Fig 2 Patient 2: A and B, Twelve months after implantation, the patient presented emergently. A computed tomography (CT) scan revealed aortic sac rupture with retroperitoneal hemorrhage. A focal endoleak was discovered adjacent to the endograft immediately distal to the overlap site. C, Intraoperative image demonstrating extensive wireframes from four endograft components after relining. Note the two proximal aortic extension marking rings. D, A CT scan approximately 2 months after relining with dense wireframe signal showing intact repair and resolution of the endoleak. Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, 51-53DOI: ( /j.jvscit ) Copyright © Terms and Conditions

4 Fig 3 A, Intravascular ultrasound examination demonstrating wireframe (straight arrows) and Sure Pass wire (curved arrow) and central lumen of endograft. B, Provoked angiogram image of a type IIIB endoleak demonstrating adequate overlap and contrast extravasation during iliac balloon occlusion. Journal of Vascular Surgery Cases and Innovative Techniques 2019 5, 51-53DOI: ( /j.jvscit ) Copyright © Terms and Conditions

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