Article ID: 2017-0006
A 46-year-old woman underwent emergent endovascular aneurysm repair for impending rupture of an abdominal aortic aneurysm. Contrast enhanced computed tomography (CT) 10 months after the procedure revealed a type 2 endoleak and enlargement of the aneurysm. Since the transarterial approach to the sac was technically difficult, direct translumbar embolization was performed. An elaster needle was inserted directly into the sac via a translumbar approach. Angiography revealed five arteries communicating with the endoleak sac. The inferior mesenteric artery and bilateral third lumbar arteries were selectively catheterized and embolized with coils. The sac and fourth lumbar arteries were embolized using an n-butyl-2-cyanoacrylate-lipiodol mixture. All of the communicating arteries and the sac were successfully embolized without severe complications. Follow-up CT images showed a reduction in the size of the aneurysm.
