Physician-modified inner-branched endovascular repair with re-intervention

Vascular. 2024 Feb 26:17085381241236569. doi: 10.1177/17085381241236569. Online ahead of print.

Abstract

Objectives: Treatment of thoracoabdominal aortic aneurysms in high surgical risk patients can be challenging. Reports of physician-modified inner-branched endovascular repair (PMiBEVAR) are increasing. Despite low morbidity and mortality rates, re-interventions for endoleaks with these grafts are serious. There are no reports of additional treatment for PMiBEVAR failure.

Methods/results: A 75-year-old man presented to our hospital with a Crawford's type IV thoracoabdominal aortic aneurysm. A PMiBEVAR was performed. Postoperative computed tomographic angiography revealed an endoleak from the inner branch of the right renal artery. A re-intervention was performed with coil embolization of the endoleak. Imaging after re-intervention showed successful obliteration of the endoleak.

Conclusions: We thereby report a successful case of re-intervention for PMiBEVAR failure.

Keywords: Physician-modified inner-branched endovascular repair; endoleak; re-intervention; thoracoabdominal aortic aneurysm.