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Rupture of an Infrarenal Aortic Aneurysm Due to a Secondary Type 1a Endoleak Following Endovascular Aneurysm Sealing with the Nellix<sup>®</sup> Device
Department of Vascular Surgery, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Germany
Department of Vascular Surgery, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Germany
Department of Diagnostic and Interventional Radiology, Neuroradiology and Nuclear Medicine, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Germany
Department of Vascular Surgery, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Germany
Department of Vascular Surgery, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Germany
- 1 Department of Vascular Surgery, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Germany
- 2 Department of Vascular Surgery, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Germany
- 3 Department of Diagnostic and Interventional Radiology, Neuroradiology and Nuclear Medicine, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Germany
- 4 Department of Vascular Surgery, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Germany
- 5 Department of Vascular Surgery, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Germany
Surgical Science·Volume 10 (2019)·Pages 398–404·Published 1 November 2019·DOI10.4236/ss.2019.1011044
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Abstract
Purpose: The Nellix endovascular aneurysm sealing (EVAS) system was introduced in 2010 for infrarenal abdominal aortic aneurysm (AAA) repair. So far one secondary type 1a endoleak resulting in rupture of the aneurysm has been reported. Case report: We present a case of a rupture of an infrarenal aortic aneurysm due to a secondary type 1a endoleak caused by stent migration 14 months after endovascular aneurysm sealing with a Nellix system. Conclusion: Strict adherence to anatomical requirements given by the instructions for use during patient selection and thorough post interventional surveillance may reduce the probability of secondary type 1a endoleaks. Furthermore, device design changes, especially concerning the configuration of the proximal part of the stent graft, have to be considered.
KeywordsEndovascular Aneurysm SealingSecondary Type 1a EndoleakRuptureAbdominal Aortic Aneurysm
- Bockler, D., Reijnen, M.M., Krievins, D., et al. (2014) Use of the Nellix EVAS System to Treat Post-EVAR Complications and to Treat Challenging Infrarenal Necks. The Journal of Cardiovascular Surgery, 55, 601-612.
- Donayre, C.E., Zarins, C.K., Krievins, D.K., et al. (2011) Initial Clinical Experience with a Sac-Anchoring Endoprosthesis for Aortic Aneurysm Repair. Journal of Vascular Surgery, 53, 574-582. https://doi.org/10.1016/j.jvs.2010.09.009
- Carpenter, J.P., Cuff, R., Buckley, C., et al. (2016) Results of the Nellix System Investigational Device Exemption Pivotal Trial for Endovascular Aneurysm Sealing. Journal of Vascular Surgery, 63, 23-31. https://doi.org/10.1016/j.jvs.2015.07.096
- Cheng, L.F., Cheung, K.F., Chan, K.M., et al. (2016) Early Enlargement of Aneurysmal Sac and Separation of EndoBags of Nellix Endovascular Aneurysm Sealing System as Signs of Increased Risk of Later Aneurysm Rupture. CardioVascular and Interventional Radiology, 39, 1654-1657. https://doi.org/10.1007/s00270-016-1416-0
- Pua, U., Quek, L.H. and Tan, G.W. (2016) Delayed Recurrence of Type 1A Endoleak with Aortic Rupture and Hemorrhage after Endovascular Aneurysm Sealing (EVAS). CardioVascular and Interventional Radiology, 39, 1061-1065. https://doi.org/10.1007/s00270-015-1291-0
- Zerwes, S., Nurzai, Z., Leissner, G., et al. (2016) Early Experience with the New Endovascular Aneurysm Sealing System Nellix: First Clinical Results after 50 Implantations. Vascular, 24, 339-347. https://doi.org/10.1177/1708538115605430
- Schmitz-Rixen, T., Torsello, G., Steinbauer, M., et al. (2016) The Endovascular Performance Spectrum of Vascular Surgery Departments in Germany. Gefabchirurgie, 21, 570-663. https://doi.org/10.1007/s00772-016-0157-3
- Oikonomou, K., Katsargyris, A. and Verhoeven, E. (2014) Indikationen zur primaren oder sekundaren Implantation von fenestrierten Stentprothesen beim hostile AAA neck. Gefabchirurgie, 19, 220-225. https://doi.org/10.1007/s00772-013-1276-8
- Navarro, T.P., de Castro Bernardes, R., Procopio, R.J., et al. (2014) Treatment of Hostile Proximal Necks during Endovascular Aneurysm Repair. AORTA, 2, 28. https://doi.org/10.12945/j.aorta.2014.13-030
- Krievins, D.K., Holden, A., Savlovskis, J., et al. (2011) EVAR Using the Nellix Sac-Anchoring Endoprosthesis: Treatment of Favourable and Adverse Anatomy. European Journal of Vascular and Endovascular Surgery, 42, 38-46. https://doi.org/10.1016/j.ejvs.2011.03.007