Treatment of a Delayed Type IIIb Endoleak 20 Years Post EVAR With Inverted Contralateral Limb Custom-Made Device: A Case Report
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Published:2022-02-28
Issue:2
Volume:30
Page:307-311
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ISSN:1526-6028
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Container-title:Journal of Endovascular Therapy
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language:en
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Short-container-title:J Endovasc Ther
Author:
Linn Yun Le1ORCID,
Tay Kiang Hiong2,
Ng Nick Zhi Peng1,
Lee Shaun Qingwei1,
Tang Tjun Yip1,
Chong Tze Tec1
Affiliation:
1. Department of Vascular Surgery, Singapore General Hospital, Singapore
2. Division of Radiological Sciences, Singapore General Hospital, Singapore
Abstract
Purpose: Type III endoleak can be difficult to distinguish from Type I endoleak. Depending on the stent graft anatomy, the use of standard bifurcated endografts may not be technically feasible, and patients may have to be subject to an aorto-uni-iliac repair with femoral-femoral bypass or open surgery. Case Report: We report a case of an 86-year-old male who had a Type IIIb endoleak 20 years post EVAR which was characterized on angiography to be from a hole close to the bifurcation limb origin. The initial Talent (Medtronic, Santa Rosa, California) device had a 50 mm main body common trunk, which was not amenable to treatment with standard devices. He was successfully treated with a custom-made device with an inverted contralateral limb. Conclusions: Our case highlights the need for lifelong surveillance post EVAR as endoleak may present decades post initial EVAR. It also demonstrates that many Type III endoleak which were otherwise deemed unsuitable for treatment with standard devices may potentially be treatable with custom-made device (CMD). This solution preserves a percutaneous option in a now older person which avoids surgical bypass. Further studies are required to establish the durability of this treatment and survey for recurrence.
Publisher
SAGE Publications
Subject
Cardiology and Cardiovascular Medicine,Radiology, Nuclear Medicine and imaging,Surgery
Cited by
1 articles.
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