PMC3268146_01
Preoperative computed tomography of abdominal aortic aneurysm (AAA) revealed aortic neck was 24 mm in diameter, 20 mm in length and 80 degrees in angulation (A). Aortic aneurysm was 66 x 74 mm in diameter (B). Right common iliac artery was 24 mm and left common iliac artery was 22 mm in diameter (C). There was an aneurysm in right internal iliac artery, which was 40 mm in diameter (D, arrow). Fig. 1E shows diagram of AAA.
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F1
Computed tomography (CT) revealed aneurysms in the abdominal aorta and right internal iliac artery measuring 66 mm and 40 mm in diameter (Fig. 1B, D). CT showed that the aortic neck was 24 mm in diameter, 20 mm in length and angulated by 80 degrees (Fig. 1A). The right iliac artery was aneurysmal measuring 24 mm in diameter and the left common iliac artery was 22 mm in diameter (Fig. 1C).
(A) Angiography showed type I endoleak in left common iliac artery. (B) Palmaz XL stent was deployed in left common iliac artery. (C) Completion angiography showed disappearance of type I endoleak after Palmaz XL stent insertion.
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F2
The angiogram after EVAR showed persistent type Ib endoleak in the left common iliac artery even after touch ballooning with Coda balloon (Cook Medical) (Fig. 2A). Balloon-expandable stent, Palmaz XL was deployed (Fig. 2B) and the type Ib endoleak in the left common iliac artery (Fig. 2C) was under control.
There was no endoleak found in aortic neck (A, B), aneurysm (C, D) and iliac arteries (E, F) on computed tomography scan in 1 month after endovascular aneurysm repair. Left common iliac artery was sealed by endograft and Palmaz XL stent (E). Right internal iliac artery was occluded by Amplatzer vascular plug (F). Endograft and Palmaz XL stent in left common iliac artery were magnified (G).
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F3
Follow-up CT in 1 month showed no endoleak (Fig. 3).