Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/S1677-54492012000200016
Jornal Vascular Brasileiro
Case Report

Endotension: rupture of abdominal aortic aneurysm

Alexandre Campos Moraes Amato; Flávio Amim Abraham; Henrique Dini Kraide; Leandro Teixeira Rocha; Ricardo Virginio dos Santos

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Abstract

Aortic endovascular exclusion technique called 'chimney' consists of placing stents through abdominal aortic visceral branches and a prosthesis that excludes the thoraco-abdominal aneurysm. Stents and an aortic endoprosthesis are placed in the renal arteries. This method is primarily used when open surgery is too risky. The mechanism that provides aneurysm sac increase without the visible presence of endoleaks has not been fully elucidated. The expansion of the aneurysm sac, due to endotension, is difficult to diagnose, even with the use of advanced imaging tests. Its diagnosis is made by exclusion. We present a case of a late complication in a high-risk patient after a 'chimney' endovascular procedure. Following the surgery, the patient presented a ruptured aneurysm sac without a visible endoleak. A second intervention was not feasible due to the high risk of occluding all of the branches, and complicated by previous 'chimney'. Endotension is a possible cause of aneurysm rupture and death.

Keywords

aortic rupture, endoleak, postoperative complications

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