- Letter to the Editor
- Open access
- Published:
Endoleak after endovascular aortic repair and lumbar vertebral erosion
Journal of Orthopaedics and Traumatology volume 16, page 75 (2015)
Dear Editor,
Mancini et al. [1] reported in their recent article an interesting clinical case on an 80-year-old man admitted to their hospital for severe low-back pain, lower limb motor impairment, and bilateral thigh pain. The patient had lumbar vertebral erosion due to an extensive infrarenal aortic false aneurysm secondary to an endovascular repair (EVAR). A CT scan performed one month after the EVAR did not show early procedural complications and the laboratotry findings performed during hospitalization were negative for infection.
Vertebral erosion secondary to an abdominal aortic aneurysm is rare. Generally, they are due to vascular prosthesis infections, chronic aneurysm rupture, or expansion. This is probably the first case secondary to EVAR. With growing numbers of interventional abdominal aortic procedures and increasing follow-up periods, complications of EVAR have become increasingly evident over time [2–5].
Via intraoperative fluoroscopy it seems that the endovascular prosthesis was a Trivascular Ovation (Trivascular Ovation Primeâ„¢, Santa Rosa, CA) comprising polymer-filled sealing rings that exert no chronic outward force. For this reason, the probability of a false aneurysm secondary to aortic neck rupture is low.
In our opinion, the cause of the false aneurysm formation is represented by the presence of an unrecognized endoleak or endotension that caused the tamponade aortic rupture.
Why was not an aortic CT scan repeated or a contrast-enhanced ultrasound (CEUS) performed?
References
Mancini F, Ascoli-Marchetti A, Garro L, Caterini R (2014) Aseptic lysis L2-L3 as complication of abdominal aortic aneurysm repair. J Orthopaed Traumatol. doi:10.1007/s10195-014-0308-9
Arici V, Rossi M, Bozzani A, Moia A, Odero A (2012) Massive vertebral destruction associated with chronic rupture of infrarenal aortic aneurysm: case report and systematic review of the literature in the English language. Spine (Phila Pa 1976) 15:E1665–E1671
Arici V, Quaretti P, Bozzani A, Moramarco LP, Rossi M, Carlino M (2014) Neck-targeted, stand-alone coiling for successful treatment of type 1° endoleak following endovascular repair. Vasc Endovasc Surg 48(1):61–64
Bozzani A, Odero A (2012) Late surgical conversion and inappropriate indications for TEVAR. Ann Thorac Surg 94(4):1376–1377
Pirrelli S, Arici V, Bozzani A, Odero A (2005) Aortic graft infections: treatment with arterial allograft. Transplant Proc 37(6):3694–3696
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
About this article
Cite this article
Bozzani, A., Arici, V., Ragni, F. et al. Endoleak after endovascular aortic repair and lumbar vertebral erosion. J Orthopaed Traumatol 16, 75 (2015). https://doi.org/10.1007/s10195-014-0329-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10195-014-0329-4