Case report of a type III endoleak presenting only decades after endovascular aortic repair

T S Q Lee; T T Chong; J C C Wang; T C E Choke; T Y Tang

doi:10.1016/j.ijscr.2019.01.008

Case report of a type III endoleak presenting only decades after endovascular aortic repair

Int J Surg Case Rep. 2019:56:10-12. doi: 10.1016/j.ijscr.2019.01.008. Epub 2019 Jan 18.

Authors

T S Q Lee¹, T T Chong², J C C Wang², T C E Choke², T Y Tang²

Affiliations

¹ Department of Vascular Surgery, Singapore General Hospital, Singapore. Electronic address: terence.lee@mohh.com.sg.
² Department of Vascular Surgery, Singapore General Hospital, Singapore.

Abstract

Introduction: Type III endoleaks are a rare but potentially life-threatening complication post endovascular aortic aneurysm repair (EVAR).

Case report: A 91-year-old Chinese female, presented to our accident and emergency department for severe back and abdominal pain. She had previously undergone an EVAR procedure twenty years ago for a 6.5 cm diameter infra-renal abdominal aortic aneurysm. A CT aortogram revealed a type III endoleak, with the contralateral limb found to be disconnected from the main graft body. She was successfully treated by relining the graft using an endovascular technique.

Discussion: The case highlights the need for life-long stent-graft surveillance. We discuss early generation stent-grafts, type III endoleak treatment options and the current long-term data for late EVAR-related complications.

Conclusion: For patients who had undergone EVAR, type III endoleaks can present only decades later and pose a significant risk of aneurysmal rupture.

Keywords: EVAR; Endoleak; Surveillance; Type III.