Conversion of endovascular aortic repair to open surgery repair for ruptured abdominal aortic aneurysm due to re-rupture and massive bleeding caused by type-2 endoleak: a case report

Abstract

　A patient transported to our center due to ruptured abdominal aortic aneurysm (rAAA) went into shock immediately after endovascular aortic repair (EVAR). Enhanced computed tomography revealed type-2 endoleak (T2EL) that improved after transcatheter arterial embolization. The retroperitoneal hematoma was removed because of significant abdominal swelling. The reduction of pressure caused a T2EL and re-rupture of the aneurysm.These issues made hemostasis difficult. Artificial blood vessel replacement surgery was performed. EVAR for rAAA can cause T2EL just after surgery, leading to re-rupture of the aneurysm. This can make it very difficult to control the patient's condition.