Raphael Coscas, MD, Roy K. Greenberg, MD, Kathryn Pfaff, BS 

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Presentation transcript:

Embolization of a type 2 endoleak through catheterization of a hypogastric branched stent-graft  Raphael Coscas, MD, Roy K. Greenberg, MD, Kathryn Pfaff, BS  Journal of Vascular Surgery  Volume 51, Issue 3, Pages 712-714 (March 2010) DOI: 10.1016/j.jvs.2009.09.007 Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 1 Three-dimensional reconstructions of the preoperative computed tomography scan showing a 58 mm juxtarenal aneurysm with bilateral involvement of the common and internal iliac arteries (right: CIA: 20 mm, IIA: 18 mm; left: CIA: 22 mm, IIA 14 mm). Journal of Vascular Surgery 2010 51, 712-714DOI: (10.1016/j.jvs.2009.09.007) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 2 The arteriography revealed a type 2 endoleak arising from the medial sacral artery (A, arrows). Glue embolization was performed after catheterization of the branched stent graft (B, arrow) and no endoleak was visible on the final angiogram (C, arrow). The computed tomography scan with 3D reconstructions performed after the procedure shows the final aspect of the repair, with a well-positioned stent-graft and the absence of endoleak (D). Journal of Vascular Surgery 2010 51, 712-714DOI: (10.1016/j.jvs.2009.09.007) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 3 Picture of a hypogastric branched stent-graft similar to the one used in the present case. The device consists of full thickness polyester fabric in conjunction with stainless steel stents fashioned in a manner similar to the Zenith device. The junction between the helical limb and tubular common iliac portion is a beveled anastomosis that mimics a surgical end-to-side anastomotic geometry. The helical branch is 8 mm in diameter and mates with a 10 mm small vessel stent-graft. The crimps in the fabric within the proximal stent improve the overall joint strength of the device. Journal of Vascular Surgery 2010 51, 712-714DOI: (10.1016/j.jvs.2009.09.007) Copyright © 2010 Society for Vascular Surgery Terms and Conditions