A patient presented with abdominal pain and fainting due to an enlarging abdominal aortic aneurysm (AAA) from an untreated type 1 endoleak following endovascular aneurysm repair (EVAR). Careful planning was used and the type 1 endoleak was radically treated by replacing the proximal part of the endoprosthesis to seal the leak and stop further AAA enlargement.

1. How to deal with a
symptomatic type 1 endoleak in
an endoprosthesis for AAA?
Guy-André Pelouze MD MSc
St John’s hospital Perpignan France

2. The case
Patient suffered of abdominal pain since 4
days
She fainted
Hypertension was not controlled
No recent follow up of the EVAR

3. The type 1
endoleak
AAA diameter is 8 cms
on the TDM

4. The repair
We use careful
planning and a radical
technique

5. Comments