Endoleaks following conventional open abdominal aortic aneurysm repair

Abstract

Objective: to describe the complication of <<<<endoleak>>>> following conventional open abdominal aortic aneurysm (AAA) repair.

Design: prospective case study.

Setting: two specialist vascular surgical centres.

Patients and methods: six patients who had successful conventional open AAA repair.

Results: six patients presented with back or abdominal pain or hypotension between one and eighteen months later. An endoleak at the distal anastomosis was noted in five of the cases and one endoleak at the proximal anastomosis. All six cases were successfully repaired; two of these patients required Dacron graft replacement, whilst in four cases only direct resuturing was needed. There was no evidence of infection.

Conclusions: an endoleak is not a phenomenon confined to stent grafts. It should be considered in all patients who present with back or abdominal pain within eighteen months of open AAA repair. The combination of computed tomography (CT) scan and digital subtraction angiography is most useful for preoperative diagnosis.