Abstract
Purpose: The Nellix endovascular aneurysm sealing (EVAS) system was introduced in 2010 for infrarenal abdominal aortic aneurysm (AAA) repair. So far one secondary type 1a endoleak resulting in rupture of the aneurysm has been reported. Case report: We present a case of a rupture of an infrarenal aortic aneurysm due to a secondary type 1a endoleak caused by stent migration 14 months after endovascular aneurysm sealing with a Nellix system. Conclusion: Strict adherence to anatomical requirements given by the instructions for use during patient selection and thorough post interventional surveillance may reduce the probability of secondary type 1a endoleaks. Furthermore, device design changes, especially concerning the configuration of the proximal part of the stent graft, have to be considered.
Highlights
Case report: We present a case of a rupture of an infrarenal aortic aneurysm due to a secondary type 1a endoleak caused by stent migration 14 months after endovascular aneurysm sealing with a Nellix system
Nellix (Endologix, Irvine, CA, USA) is an endovascular aneurysm sealing (EVAS) system introduced in 2010 to overcome certain difficulties associated with endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms
The Nellix system consists of two balloon expandable stents providing the blood flow lumen through the aneurysm to the iliac arteries, each surrounded by a polyurethane endobag which is inflated and filled with a polymer sealing the aneurysmal sac to prevent retrograde blood flow and to stabilize the stents to avoid stent migration [2]
Summary
Nellix (Endologix, Irvine, CA, USA) is an endovascular aneurysm sealing (EVAS) system introduced in 2010 to overcome certain difficulties associated with endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms. The Nellix system consists of two balloon expandable stents providing the blood flow lumen through the aneurysm to the iliac arteries, each surrounded by a polyurethane endobag which is inflated and filled with a polymer sealing the aneurysmal sac to prevent retrograde blood flow and to stabilize the stents to avoid stent migration [2]. Only a few postoperative complications leading to conversion to surgery or rupture have been reported [3] [4] [5] [6]. In 2016 we observed for the first time a rupture of an infrarenal aortic aneurysm due to a secondary type 1a endoleak in a patient who had undergone EVAS using a Nellix system. This paper is to share the case and to discuss the possible causes and consequences
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