Use of a bifurcated endovascular graft for treatment of endograft migration with major endoleak

Vascular. 2012 Feb;20(1):49-53. doi: 10.1258/vasc.2011.cr0285. Epub 2011 Nov 29.

Abstract

The purpose of this study was to describe the use of a bifurcated endovascular graft to treat endograft migration with major endoleaks. We present four patients who presented at a mean of 72.0 months after their initial endovascular abdominal aortic aneurysm repair. Three patients had type I endoleaks resulting from proximal attachment failure and graft migration. A fourth patient had separation of a proximal aortic cuff from a migrated main body device resulting in a type III endoleak. All were treated with a bifurcated Zenith (Cook Medical Incorporated, Bloomington, IN, USA) endovascular graft. There was 100% technical success with no perioperative complications. On follow-up, one patient died of unrelated causes at five months. The mean survival for the remaining three patients was 37 months. In conclusion, treatment with a bifurcated Zenith endograft has advantages over the use of an aortic cuff or aortouniiliac reconstruction. To perform this technique, there must be a sufficient distance between the proximal landing zone and the flow divider of the migrated endograft to allow for deployment of the Zenith device. While there remain limitations in its applicability, the use of a bifurcated endovascular graft is a viable alternative for endovascular salvage in treatment of endograft migration with major endoleaks.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortography / methods
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Endoleak / diagnostic imaging
  • Endoleak / etiology
  • Endoleak / surgery*
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Female
  • Foreign-Body Migration / diagnostic imaging
  • Foreign-Body Migration / etiology
  • Foreign-Body Migration / surgery*
  • Humans
  • Male
  • Prosthesis Design
  • Prosthesis Failure*
  • Reoperation
  • Tomography, X-Ray Computed
  • Treatment Outcome