Abstract
To assess viability and safety of preemptive treatment of type II endoleak for abdominal aortic aneurysm (AAA) repairs. A 69-year-old man with renal fusion (horseshoe kidney) was referred for treatment of a 5.5cm AAA. His anatomy was suitable for endovascular repair. The risk for type II endoleak was increased because of multiple infrarenal arterial orifices originating within the aneurysm sac. These included an accessory renal artery that supplied the renal isthmus, a patent inferior mesenteric artery, and a pair of large lumbar arteries originating from a single orifice (8mm) at L3 spinal level. The lumbar orifice was selectively cannulated and occluded with thrombogenic coils 1week prior to his endovascular aneurysm repair. Aneurysm repair was uneventful with no signs of early or delayed endoleak and long-term follow-up of 5years. Preemptive coil embolization of perianeurysmal arteries may be considered as a safe and effective strategy for management of potential type II endoleak.
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