Progressive growth of a pelvic collection five years after endovascular aneurysm repair: An atypical presentation of an asymptomatic contained rupture

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Presentation transcript:

Progressive growth of a pelvic collection five years after endovascular aneurysm repair: An atypical presentation of an asymptomatic contained rupture Olivier Bladt, MD, Geert Maleux, MD, Sam Heye, MD, Dirk Vanbeckevoort, MD, André Nevelsteen, MD, PhD Journal of Vascular Surgery Volume 43, Issue 1, Pages 172-176 (January 2006) DOI: 10.1016/j.jvs.2005.08.036 Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 1 A, A computed tomography (CT) scan of the aortobiiliac aneurysm before endovascular repair (EVAR). B, A control CT scan 1 year after EVAR shows that both iliac aneurysms are completely excluded by the stent-graft. The size of the aneurysmal sacs remained the same compared with the size before the operation. Journal of Vascular Surgery 2006 43, 172-176DOI: (10.1016/j.jvs.2005.08.036) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 2 A, Axial and (B) reconstructed coronal slices of the excluded aneurysm 5 years after EVAR clearly show the homogeneous, thin-walled pelvic collection (*) located close to the excluded iliac aneurysms and above the roof of the bladder. Journal of Vascular Surgery 2006 43, 172-176DOI: (10.1016/j.jvs.2005.08.036) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 3 A computed tomography scan obtained immediately after percutaneous drainage of the collection shows absence of any pelvic collection and clear shrinkage of both iliac aneurysms (arrows). Journal of Vascular Surgery 2006 43, 172-176DOI: (10.1016/j.jvs.2005.08.036) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 4 A perioperative view into the drained right iliac aneurysm shows the right iliac limb of the Zenith stent-graft (arrows). The tweezers are placed in the hole (arrowhead) communicating between the aneurysm and the pelvic collection. Journal of Vascular Surgery 2006 43, 172-176DOI: (10.1016/j.jvs.2005.08.036) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 5 A, Axial and (B) reconstructed coronal slices of the aortobiiliac aneurysm 5 months after surgical resection of the collection show absence of clear growth of the excluded iliac aneurysms. Note the vascular coils in the left proximal internal iliac artery (arrow). Journal of Vascular Surgery 2006 43, 172-176DOI: (10.1016/j.jvs.2005.08.036) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions