Endotension: rupture of abdominal aortic aneurysm

Aortic endovascular exclusion technique called 'chimney' consists of placing stents through abdominal aortic visceral branches and a prosthesis that excludes the thoraco-abdominal aneurysm. Stents and an aortic endoprosthesis are placed in the renal arteries. This method is primarily used when open surgery is too risky. The mechanism that provides aneurysm sac increase without the visible presence of endoleaks has not been fully elucidated. The expansion of the aneurysm sac, due to endotension, is difficult to diagnose, even with the use of advanced imaging tests. Its diagnosis is made by exclusion. We present a case of a late complication in a high-risk patient after a 'chimney' endovascular procedure. Following the surgery, the patient presented a ruptured aneurysm sac without a visible endoleak. A second intervention was not feasible due to the high risk of occluding all of the branches, and complicated by previous 'chimney'. Endotension is a possible cause of aneurysm rupture and death.

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Bibliographic Details
Main Authors: Amato,Alexandre Campos Moraes, Abraham,Flávio Amim, Kraide,Henrique Dini, Rocha,Leandro Teixeira, Santos,Ricardo Virginio dos
Format: Digital revista
Language:English
Published: Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) 2012
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492012000200016
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