Jip L. Tolenaar, MD, Jasper W. van Keulen, MD, Vanessa J

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A ruptured aneurysm after stent graft puncture during computed tomography-guided thrombin injection Jip L. Tolenaar, MD, Jasper W. van Keulen, MD, Vanessa J. Leijdekkers, MD, Evert-Jan Vonken, MD, PhD, Frans L. Moll, MD, PhD, Joost A. van Herwaarden, MD, PhD Journal of Vascular Surgery Volume 52, Issue 4, Pages 1045-1047 (October 2010) DOI: 10.1016/j.jvs.2010.04.074 Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 1 A, Computed tomography (CT) imaging on the second postoperative day shows aneurysm reduction from 8.4 to 7.8 cm, with no evident endoleak. B, At 2 years, the aneurysm had grown to 11 cm, but there was no evident endoleak. C, CT imaging of the second thrombin injection shows the needle clearly positioned outside the stent graft. D, CT imaging 2 weeks after the second thrombin injection shows aneurysm rupture and extravasation of contrast (arrow) due to a type III endoleak. Journal of Vascular Surgery 2010 52, 1045-1047DOI: (10.1016/j.jvs.2010.04.074) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 2 A three-dimensional volumetric reconstruction shows a type III endoleak originating in the main device of the stent graft. The yellow arrow indicates the puncture hole, and the red circle shows contrast extravasation. Journal of Vascular Surgery 2010 52, 1045-1047DOI: (10.1016/j.jvs.2010.04.074) Copyright © 2010 Society for Vascular Surgery Terms and Conditions