A Modified Technique of Open Surgical Treatment for Aneurysmal Sac Enlargement after Endovascular Repair

Introduction

Although several articles have reported the successful treatment of an abdominal aortic aneurysm (AAA) enlargement after endovascular aortic repair (EVAR) due to endoleak or endotension, the strategy to treat this type of complication is still controversial.

Report

We report three cases of AAA expansion after EVAR. When other endovascular approaches were not considered effective, we performed a modified open surgical treatment.

Discussion

This technique includes ligation of all branched vessels arising from the aneurismal sac, plication of the aneurysm and wrapping of the aneurysm using bio-prosthetic material instead of explanting the implanted endovascular graft.