Successful endovascular management of endoleak-like phenomenon following open abdominal aortic aneurysm repair

INTRODUCTION: Endoleaks are a well-known complication after endovascular aortic repair. Type I endoleak-like phenomenon (also defined as a proximal pseudoaneurysm) post-open abdominal aortic aneurysm (AAA) repair is described as an anastomotic leak causing recurrent pressurization of the original aneurysm sac. It is rare but may result in aneurysmal sac rupture into the peritoneal cavity. REPORT: A 78-year-old man presented with a progressively enlarged aneurysmal sac due to proximal anastomotic degeneration of the proximal suture line associated with an outflow through a patent large lumbar vessel following a previous emergency open AAA repair. This was successfully treated using a combination coils and ethylene-vinyl alcohol copolymer. An Endoluminal tube stent graft was successfully deployed to seal the aortic anastomotic dehiscence. CONCLUSION: Endovascular treatment of an anastomotic dehiscence associated with a large outflow lumbar artery post-open AAA repair is feasible and safe.