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Early Enlargement of Aneurysmal Sac and Separation of EndoBags of Nellix Endovascular Aneurysm Sealing System as Signs of Increased Risk of Later Aneurysm Rupture

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Abstract

Nellix Endovascular Aneurysm Sealing (EVAS) system is a new concept and technology of abdominal aortic aneurysm (AAA) repair. Elective EVAS using Nellix device was performed for a 83-year-old man with AAA. 2-month post-EVAS CTA surveillance demonstrated mild enlargement of aneurysmal sac and separation of the EndoBags, but without detectable endoleak. The patient developed sudden AAA rupture with retroperitoneal hematoma at about 4 months after EVAS. We postulated that early enlargement of aneurysmal sac and separation of EndoBags of Nellix devices after EVAS, even without detectable endoleak, might indicate significant aneurysmal wall weakening with increased risk of later AAA rupture. To the best of the authors’ knowledge, this was the first reported case of aortic rupture after EVAS without detectable endoleak during and after the procedure.

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Authors and Affiliations

  1. Department of Radiology, Princess Margaret Hospital, 2-10 Princess Margaret Hospital Road, Lai Chi Kok, Kowloon, Hong Kong SAR, China

    Lik Fai Cheng, Johnny Ka Fai Ma, Wing Hang Luk, Carol Wing Kei Ng, Neeraj Ramesh Mahboobani & Ting Wong

  2. Department of Surgery, Princess Margaret Hospital, Hong Kong SAR, China

    Kwok Fai Cheung, Kwong Man Chan, Micah Chi King Chan & Wai Kin Ng

Authors
  1. Lik Fai Cheng
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  2. Kwok Fai Cheung
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  3. Kwong Man Chan
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  4. Johnny Ka Fai Ma
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  5. Wing Hang Luk
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  6. Micah Chi King Chan
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  7. Carol Wing Kei Ng
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  8. Neeraj Ramesh Mahboobani
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  9. Wai Kin Ng
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  10. Ting Wong
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Correspondence to Lik Fai Cheng.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Cheng, L.F., Cheung, K.F., Chan, K.M. et al. Early Enlargement of Aneurysmal Sac and Separation of EndoBags of Nellix Endovascular Aneurysm Sealing System as Signs of Increased Risk of Later Aneurysm Rupture. Cardiovasc Intervent Radiol 39, 1654–1657 (2016). https://doi.org/10.1007/s00270-016-1416-0

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  • DOI: https://doi.org/10.1007/s00270-016-1416-0

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