ENDOLEAK TIPO IIIB: A CASE REPORT

  • Miguel Lemos Gomes Serviço de Cirurgia Vascular, Hospital de Santa Maria (CHLN), Lisboa; Centro Académico de Medicina de Lisboa, Portugal
  • Alice Lopes Serviço de Cirurgia Vascular, Hospital de Santa Maria (CHLN), Lisboa; Centro Académico de Medicina de Lisboa, Portugal
  • Gonçalo Sobrinho Serviço de Cirurgia Vascular, Hospital de Santa Maria (CHLN), Lisboa; Faculdade de Medicina da Universidade de Lisboa; Centro Académico de Medicina de Lisboa, Portugal
  • Karla Ribeiro Serviço de Cirurgia Vascular, Hospital de Santa Maria (CHLN), Lisboa; Centro Académico de Medicina de Lisboa, Portugal
  • João Leitão Serviço de Radiologia, Hospital de Santa Maria (CHLN), Lisboa, Portugal
  • Luís Mendes Pedro Serviço de Cirurgia Vascular, Hospital de Santa Maria (CHLN), Lisboa; Faculdade de Medicina da Universidade de Lisboa; Centro Académico de Medicina de Lisboa, Portugal
Keywords: Aneurysm, Endoleak, Omentoplasty

Abstract

The endovascular aneurysm repair (EVAR) allowed a reduction of short-term morbidity and mortality; however, late endoleaks are a permanent cause of concern. Type IIIb endoleaks arise from a defect in the endograft and are associated with a high risk of rupture. In this paper, the authors describe the case of an 81-year-old male patient, submitted in 2013 to EVAR due to an abdominal aortic aneurysm of 87mm. Aneurysmatic sac growth was observed after the first 2 years, reaching 100 mm, without any evidence of endoleaks. The patient underwent open surgery: the aneurysmatic sac was opened, and a type IIIb endoleak was diagnosed; hemostasis and omentoplasty were performed.

Late type IIIb endoleaks are difficult to diagnose, sometimes only upon opening of the aneurysmatic sac. Given the potential for severe complications, correction of this type of endoleaks is indicated. The open approach allows a definitive correction, and is an option to consider.

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References

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Published
2020-04-30
Section
Clinical Case