Abstract
We report a case of late conversion for abdominal aortic aneurysm (AAA) dilatation caused by a type II endoleak after endovascular aneurysm repair (EVAR). A 77-year-old man underwent EVAR for AAA in September 2007. Postoperative computed tomography (CT) showed type Ib endoleak and he received treatment of transarterial embolization and EVAR. However, the type II endoleak remained; he was followed up in an outpatient clinic, and was subsequently admitted for open surgery in April 2011. His lumbar arteries were clipped from the external aspect with a transperitoneal approach and the aneurysm was incised. Stent explantation was not required. Transarterial or translumbar embolization is the main treatment for a type II endoleak after EVAR, but there are few reports of either surgical approach in Japan. The current method might be less invasive, and it is unnecessary to remove the stent and perform replacement with a new graft.
