- Letter to the Editor
- Open access
- Published:
Reply to the Letter to the Editor. Endoleak after endovascular aortic repair and lumbar vertebral erosion
Journal of Orthopaedics and Traumatology volume 16, pages 77–78 (2015)
We thank Bozzani and co-workers for their comments [1] regarding this case [2]. It has been emphasized that this type of endoprosthesis does not generally promote rupture. In fact, in the most recent international trial, the incidence of type II endoleak (i.e., abnormal persistent post-endovascular aneurysm repair (EVAR) filling of the aneurysm sac through one or more of the branch vessels) after infrarenal implantation of a polymer-filled endovascular prosthesis was reported to be 34 % [3]; however, a significant increase in the diameter was documented in only one case (0.7 %). Moreover, ruptures did not result at 12-month follow-up but further observation has been recommended [4]. However, in this case the delay between implantation and the occurrence of an aneurysm was less than 1 year. We agree that in most cases the tamponade aortic rupture is determined by an endoleak or endotension. In this case, however, the aneurysm was extremely large (6.2-cm in diameter, Fig. 1), and this condition has been documented as a risk factor for rupture, including in well-positioned vascular endoprosthesis [5]. A computed tomography (CT) scan performed after the spinal procedure did not reveal any signs of an endoleak or bleeding (Fig. 2).
CT scan performed after EVAR procedure. The aneurysm was >6 cm in diameter
CT scan performed after spinal surgery showing the absence of infra/suprarenal endoleak
References
Bozzani A, Arici V, Ragni F, Argenteri A (2014) Endoleak after endovascular aortic repair and lumbar vertebral erosion. J Orthopaed Traumatol. doi:10.1007/s10195-014-0329-4
Mancini F, Ascoli-Marchetti A, Garro L, Caterini R (2014) Aseptic lysis L2-L3 as complication of abdominal aortic aneurysm repair. J Orthopaed Traumatol 15(4):291–294. doi:10.1007/s10195-014-0308-9
Mehta M, Valdés FE, Nolte T, Mishkel GJ, Jordan WD, Gray B, Eskandari MK, Botti C; A Pivotal Clinical Study to Evaluate the Safety and Effectiveness of the Ovation Abdominal Stent Graft System Investigators (2014) One year outcomes from an international study of the Ovation Abdominal Stent Graft System for endovascular aneurysm repair. J Vasc Surg 59(1):65.e1-3–73.e1-3. doi:10.1016/j.jvs.2013.06.065
Keith CJ Jr, Passman MA, Gaffud MJ, Novak Z, Pearce BJ, Matthews TC, Patterson MA, Jordan WD Jr (2013) Comparison of outcomes following endovascular repair of abdominal aortic aneurysms based on size threshold. J Vasc Surg 58(6):1458–1466. doi:10.1016/j.jvs.2013.06.060
Greiner A, Schleimer K, Jalaie H, Gombert A, Jacobs MJ, Kalder J (2014) Late rupture after EVAR: a new trend? J Cardiovasc Surg (Torino) 55(2 Suppl 1):169–174
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
Mancini, F., Ascoli-Marchetti, A., Garro, L. et al. Reply to the Letter to the Editor. Endoleak after endovascular aortic repair and lumbar vertebral erosion. J Orthopaed Traumatol 16, 77–78 (2015). https://doi.org/10.1007/s10195-015-0336-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10195-015-0336-0