Open repair of type Ia endoleak in the aortic arch: three tailored approaches

Gelsomino, Sandro; Bidar, Elham; Lorusso, Roberto; Johnson, Daniel M.; Maessen, Jos G. and Natour, Ehsan (2018). Open repair of type Ia endoleak in the aortic arch: three tailored approaches. Journal of Thoracic Disease, 10(11) pp. 6261–6265.



Endoleaks are an important complication following hybrid thoracic endovascular aortic repair (TEVAR) with an incidence ranging from 20% to 25%. There are five different types of endoleaks, which are classified based on the source of vessels that cause the inflow into the aneurysm sac. Type I endoleaks (EL-I) occur at either the proximal (Ia) or distal (Ib) attachment sites and can be seen during insertion of the initial stent graft or during a follow-up surveillance imaging exam. EL-I may be secondary to incomplete dilatation or inaccurate sizing of the stent graft, diseased aortic wall or aortic tortuosity with angulations, leading to higher chances of rupture. However, EL-I represent a technical failure of endovascular repair that should be corrected promptly. However, endovascular EL-I repair at the level of aortic arch is not always possible due to an improper landing zone in the ascending aorta making it technically challenging. In the present paper, we describe three cases of EL-Ia following TEVAR and we address different repair techniques.

Written informed consents were obtained from the patients for publication of the article and any accompanying images.

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