A Case of Thoracoabdominal Open Conversion after EVAR with Type V Endoleak

• Published in: Japanese Journal of Vascular Surgery Vol. 29; no. 4; pp. 265 - 269
• Main Authors: Amako, Mau, Hayama, Masato, Wada, Hideichi, Suzuki, Hiroyuki, Matsumura, Hitoshi
• Format: Journal Article
• Language: Japanese
• Published: JAPANESE SOCIETY FOR VASCULAR SURGERY 26.08.2020; 特定非営利活動法人 日本血管外科学会
• Subjects: AAA; EVAR; open surgery; Type V endoleak; 経カテーテル的ステントグラフト内挿術; 腹部大動脈瘤; 開腹手術
• ISSN: 0918-6778; 1881-767X
• DOI: 10.11401/jsvs.20-00022

The case, 76-year-old man underwent endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm with maximum diameter of 75 mm 4 years ago. The patient was referred to our hospital for back pain, anemia and gastrointestinal bleeding. CT showed an enlarged abdominal aortic aneurysm with maximum diameter 90 mm, and no endoleak. An urgent surgical repair was performed using thoracoabdominal aortic aneurysm surgery approach. The aneurysm sac was found to be filled with gelatinous material without evidence of thrombus or active bleeding, so we diagnosed enlargement of the aneurysm as Type V endoleak. The postoperative course was uneventful and there was no particular problem with postoperative CT. Thoracoabdominal approach provides good surgical fields and is very useful to control proximal aorta in cases of open conversion after EVAR.