Wei Zhou

Publication Details

  • Successful treatment of endotension and aneurysm sac enlargement with endovascular stent graft reinforcement JOURNAL OF VASCULAR SURGERY Kougias, P., Lin, P. H., Dardik, A., Lee, W. A., El Sayed, H. F., Zhou, W. 2007; 46 (1): 124-127


    Abdominal aortic aneurysm (AAA) enlarges after successful endovascular repair because of endoleak, which is persistent blood flow within the aneurysm sac. In the absence of detectable endoleak, AAA may still expand, in part because of endotension, which is persistent pressurization within the excluded aneurysm. We report three patients who underwent successful endovascular AAA repair using the Excluder device (W. L. Gore & Associates, Flagstaff, Ariz). Although their postoperative surveillance showed an initial aneurysm regression, delayed aneurysm enlargement developed in all three, apparently due to endotension. Endovascular treatment was performed in which endograft reinforcement with a combination of aortic cuff and iliac endograft extenders were inserted in the previously implanted stent grafts. The endograft reinforcement procedure successfully resulted in aneurysm sac regression in all three patients. Our study underscores the significance of increased graft permeability as a mechanism of endotension and delayed aneurysm enlargement after successful endovascular AAA repair. In addition, our cases illustrate the feasibility and efficacy of an endovascular treatment strategy when endotension and aneurysm sac enlargement develops after endovascular AAA repair.

    View details for DOI 10.1016/j.jvs.2007.02.067

    View details for Web of Science ID 000247707500021

    View details for PubMedID 17606128

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