Anastomotic false aneurysm of the aorta: closure with a "sandwiched" coil

J Endovasc Ther. 2015 Jun;22(3):466-9. doi: 10.1177/1526602815579902. Epub 2015 Apr 10.

Abstract

Purpose: To describe the treatment of a noninfected saccular anastomotic false aneurysm (AFA) of the abdominal aorta with the use of a single "sandwiched" coil.

Case report: A 65-year-old man presented with a saccular AFA of the distal anastomosis exactly at the level of the aortic bifurcation 1 month after open abdominal aortic aneurysm repair. Endograft exclusion was not attempted because an aortouni-iliac configuration would have sacrificed a patent iliac axis. Coil embolization was the preferred strategy. Use of 3-dimensional rotational angiography and 3-dimensional roadmap was necessary to cannulate the neck of the AFA. Complete thrombosis and shrinkage of the sac was achieved by "sandwich coiling" of the neck after deployment of a single pushable hydrogel-coated coil. Imaging at 9 months postprocedure showed no sign of the aneurysm sac.

Conclusion: This novel technique can be used for selected saccular AFAs with a narrow neck. In such cases, sandwich coiling may avoid sacrifice of a patent iliac axis.

Keywords: abdominal aortic aneurysm; anastomotic false aneurysm; coil embolization; hydrogel-coated coil; pseudoaneurysm.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anastomosis, Surgical
  • Aneurysm, False / diagnostic imaging
  • Aneurysm, False / etiology
  • Aneurysm, False / therapy*
  • Aortic Aneurysm, Abdominal / diagnosis
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortography / methods
  • Blood Vessel Prosthesis Implantation / adverse effects*
  • Embolization, Therapeutic / instrumentation*
  • Endovascular Procedures / adverse effects*
  • Humans
  • Male
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome