A Case of Late Surgical Conversion for Type II Endoleak after EVAR

Hideaki Kanda	Hiroyuki Yamamoto	Yosuke Hisashi
Yoshiya Shigehisa	Hirokazu Kawazu and Yutaka Imoto

（Cardiovascular and Gastrointestinal Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan）

Type II endoleak after stent graft for abdominal aortic aneurysm generally permits a wait-and-see approach, however, additional second therapy is necessary if the aneurysm increases. A 78-year-old woman had undergone endovascular treatment with a stent-graft for abdominal aortic aneurysm. Computed tomography（CT）3 months after the operation showed type II endoleak, and enlargement of the aneurysm was noted at 1 year. She underwent transarterial embolization for third and fourth lumbar arteries, but endoleak from the fourth lumbar artery remained, and the aneurysm was further enlarged. Surgical conversion was performed 2 years after the first operation. We applied a ligature to the forth lumbar artery by a laparotomy. Postoperative CT revealed disappearance of the endoleak. As endovascular treatment for abdominal aortic aneurysm is increasing and the number of cases necessitating additional therapy appears to be rising, we need to develop processes and strategies for coping with endoleaks.

　

Jpn. J. Cardiovasc. Surg. 43:105-107（2014）

Keywords：abdominal aneurysm;stent-graft;type II endoleak