Type IIIb Endoleak of Aortic Sac Enlargement after Endovascular Aortic Repair—A Case Report—

Abstract

An 86-year-old man visited our hospital for treatment of an abdominal aortic aneurysm (AAA) that was 46 mm in diameter. Endovascular aortic repair (EVAR) was chosen. Three years after EVAR, the AAA was 55 mm in diameter. Enhanced computed tomography (CT) and angiography showed no endoleak (EL) into the AAA, and a wait-and-see approach was adopted, with oral administration of tranexamic acid. The tranexamic acid therapy with no interruption was not effective for the treatment of enlargement of the AAA after EVAR. Four years after EVAR, since the AAA was already 59 mm in diameter, open conversion was chosen. This case was diagnosed as a type IIIb EL based on the intraoperative findings, because of arterial bleeding from the fabric of the stent graft. Postoperatively, this case showed good progress.