[MO-79] Presentation Awards
Endoleaks detected by open surgery that could not be identified preoperative computed tomography after EVAR.
A 70s-year-old man with an abdominal aortic aneurysm (AAA) of maximum short diameter 62mm was treated by endovascular abdominal aortic aneurysm repair (EVAR). We had a follow-up the Type Ⅱendoleak of the final angiography. He was underwent embolization of the lumber artery due to Type Ⅱendoleak and expansion of the AAA with 72mm diameter after 27 months from EVAR. Although the endoleak was disappeared after treatment, computed tomography after 53 months from EVAR showed that the AAA had grown to 79mm in diameter and suspected endoleak with another lumber artery. We decided to perform open surgery. The source of endoleak was unclear, only we dissected the AAA at first. Removing the thrombus in the AAA, endoleak from a lumber artery was found. Further to remove the thrombus, we detected another leakage from the proximal stent graft that could not be identified preoperative computed tomography. We ligating the lumber artery and sutured the neck of aorta and the stent graft. There was no dilatation of the AAA after surgery and we observed this case in up to now.