TY - JOUR
T1 - A Late Post-EVAR Rupture in a 102-Year-Old Patient Related to a Type II Endoleak
AU - Gonzalez-Urquijo, Mauricio
AU - Reijnen, Michel M.P.J.
AU - Lozano-Balderas, Gerardo
AU - Fabiani, Mario Alejandro
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Purpose: Endovascular abdominal aortic aneurysm repair (EVAR) is progressively being applied in the elderly population. Type II endoleaks are common and mostly benign, but they are related to more aneurysm sac expansion after EVAR. They may lead to rupture in <1% of cases. We present a case of a centenarian with a post-EVAR rupture, related to type II endoleak, and discuss the use of EVAR on the management of this type of endoleak in an extremely old patient.Case Presentation: A 102-year-old man with a history of EVAR 12 years earlier, presented to the emergency department with a drop of consciousness. A computed tomography revealed a ruptured abdominal aortic aneurysm. Angiography showed a type II endoleak related to patent lumbar arteries deriving from collateral branches of the right internal iliac artery. Embolization was not successful and subsequently the ostium of the iliolumbar artery was overstented, obliterating the feeding branch. The postoperative course was complicated by a deterioration of chronic obstructive pulmonary disease and patient was discharged home on the seventh postprocedural day; nonetheless, he died on postoperative day sixteenth due to respiratory complications.Conclusion: Complications following EVAR are a real threat and emphasize the need for follow-up. The current case report shows that age per se should not be a contraindication for EVAR nor for follow-up. Also, late ruptures due to type II endoleaks could be treated in the very elderly population although larger series are required for robust conclusions.
AB - Purpose: Endovascular abdominal aortic aneurysm repair (EVAR) is progressively being applied in the elderly population. Type II endoleaks are common and mostly benign, but they are related to more aneurysm sac expansion after EVAR. They may lead to rupture in <1% of cases. We present a case of a centenarian with a post-EVAR rupture, related to type II endoleak, and discuss the use of EVAR on the management of this type of endoleak in an extremely old patient.Case Presentation: A 102-year-old man with a history of EVAR 12 years earlier, presented to the emergency department with a drop of consciousness. A computed tomography revealed a ruptured abdominal aortic aneurysm. Angiography showed a type II endoleak related to patent lumbar arteries deriving from collateral branches of the right internal iliac artery. Embolization was not successful and subsequently the ostium of the iliolumbar artery was overstented, obliterating the feeding branch. The postoperative course was complicated by a deterioration of chronic obstructive pulmonary disease and patient was discharged home on the seventh postprocedural day; nonetheless, he died on postoperative day sixteenth due to respiratory complications.Conclusion: Complications following EVAR are a real threat and emphasize the need for follow-up. The current case report shows that age per se should not be a contraindication for EVAR nor for follow-up. Also, late ruptures due to type II endoleaks could be treated in the very elderly population although larger series are required for robust conclusions.
KW - Centenarian
KW - EVAR
KW - rAAA
KW - Rupture
KW - Type II endoleak
KW - n/a OA procedure
UR - http://www.scopus.com/inward/record.url?scp=85089857832&partnerID=8YFLogxK
U2 - 10.1177/1538574420945447
DO - 10.1177/1538574420945447
M3 - Article
AN - SCOPUS:85089857832
SN - 1538-5744
VL - 54
SP - 729
EP - 733
JO - Vascular and Endovascular Surgery
JF - Vascular and Endovascular Surgery
IS - 8
ER -