CASE REPORT
Year : 2014  |  Volume : 1  |  Issue : 1  |  Page : 29-32

Management of Complex Type Iiia Endoleak by Brachio-femoral Realignment and Interposition Stent Graft and Review of the Literature


Department of Vascular Surgery, Narayana Institute of Vascular Sciences, Narayana Hrudaylaya Hospitals, Bengaluru, Karnataka, India

Correspondence Address:
Himanshu Verma
Department of Vascular Surgery, Narayana Institute of Vascular Sciences, Narayana Hrudaylaya Hospitals, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-0820.142367

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EVAR has emerged as procedure of choice for morphologically suitable AAAs. Due to direct perfusion of aneurysm sac at systemic blood pressure, types I & III endoleaks are indicated for interventions even when patients are asymptomatic or have stable aneurysm size. Disconnection of components of modular endograft system and defect in the stent-covering graft fabric has been classified as type III a & b endoleaks respectively. Due to an overall smaller incidence, descriptive management of Type III endoleaks has been limited to very few case reports and needs to be individualized. We present a case of complex Type III a endoleak, 2 years following EVAR, where complete disjunction of main body and contralateral limb occurred with increase in aneurysm sac diameter. It was managed by brachio-femoral realignment and interposition stent graft. We also review the current literature on type III endoleak, its classification , risk factors and their management in current practice.


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