Successful Type II Endoleak Closure by Subclavian-to-Carotid Artery Transposition After Stent-Graft Placement of a Distal Aortic Arch Aneurysm

Abstract

Endovascular stent-graft placement has become a safe and effective treatment modality for various diseases of the distal aortic arch as well as of the descending aorta [[1], [2], [3], [4], [5]]. However, its effectiveness may be limited by various kinds of endoleaks resulting in persistent or recurrent perfusion of the aneurysm sac [[6], [7]]. Subsequently, systemic pressurization leads to expansion of the aneurysm sac, exposing the patient to a recurrent risk of aneurysm rupture. We report on the case of a 57-year-old male who underwent emergency stent-graft placement in March 2001 due to a contained rupture of a distal aortic arch aneurysm involving the origin of the left subclavian artery. Due to the emergency condition, a subclavian-to-carotid artery transposition had not been performed prior to stent-graft placement. During follow-up the patient developed a type II endoleak originating from the left subclavian artery with consecutive enlargement of the aneurysm sac. The endoleak was successfully treated by subclavian-to-carotid artery transposition.

Aortic disease - endovascular stent-graft - endoleak

References

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