PMC7475786_01
Preoperative angio-CT:drawing patient 1 showing the type 1a endoleak.
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An US and computed tomographic (CT) scan showed an IaEL in a 64 mm aneurysm diameter (Figure 1).
PMC7475786_02
Intraoperative image: (a) preliminary angiogram; (b) post relining-chimney; (c) endoanchors implant; (d) final angiogram (red arrow: endoleak).
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A preliminary angiogram confirmed the IaEL (Figure 2(a)). An angiogram check showed persistent endoleak, even though with flow reduction (Figure 2(b)). Therefore, implant of Heli-FX (Medtronic, USA) endoanchors was performed using multiple devices on inflow endoleak side (Figure 2(c)). The final angiogram showed the endoleak resolution (Figure 2(d)).
Preoperative (a) and postoperative (b) angio-CT patient 2 (red arrow: endoleak, blue arrows: closeness visceral vessels).
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IaEL with inflow close to left renal artery (Figure 4(a)), confirming the aortic diameter increase. In both cases, a graft distal migration and distal enlargment were detected.