Sharma K, Halandras P, Milner R
Central Michigan University College of Medicine, Mount Pleasant, MI, USA.
Division of Vascular Surgery and Endovascular Therapy, Loyola University Medical Center, Maywood, IL, USA.
EJVES Short Rep. 2016 Oct 10;33:24-26. doi: 10.1016/j.ejvssr.2016.09.002. eCollection 2016.
An endoleak is a common complication following EVAR. Specifically, a Type 2 endoleak occurs because of retrograde flow from lumbar vessels outside the endograft within the aneurysm sac. Even though it is common following EVAR, it has not been identified as a complication following open ruptured abdominal aortic aneurysm (AAA) repair.
A 73-year-old male underwent open repair of a ruptured AAA. Five months later, computed tomography revealed filling from a lumbar vessel mimicking a Type 2 "endoleak." The initial ultrasound showed a single pair of lumbar vessels with aneurysm sac expansion 8 weeks later. The "endoleak" and expanding sac were treated, and the 2-year surveillance demonstrated sac shrinkage.
Because endoleak is a complication after EVAR, this case provides a unique presentation of Type 2 "endoleak" physiology following open repair of a ruptured AAA. It is believed that it is necessary to expand the list of possible complications after open ruptured AAA repair to include "endoleaks."
内漏是腔内修复腹主动脉瘤（EVAR）术后常见的并发症。具体而言，Ⅱ型内漏是由于动脉瘤腔内移植物外的腰动脉出现逆向血流所致。尽管其在EVAR术后很常见，但在开放性破裂腹主动脉瘤（AAA）修复术后尚未被认定为一种并发症。
一名73岁男性接受了开放性破裂AAA修复术。五个月后，计算机断层扫描显示来自腰动脉的充盈，类似Ⅱ型“内漏”。最初的超声检查显示8周后有一对腰动脉伴有动脉瘤腔扩张。对“内漏”和扩张的瘤腔进行了治疗，两年的随访显示瘤腔缩小。
由于内漏是EVAR术后的并发症，该病例呈现了开放性破裂AAA修复术后Ⅱ型“内漏”生理学的独特表现。据信有必要扩大开放性破裂AAA修复术后可能并发症的范围，将“内漏”包括在内。
