Jornal Vascular Brasileiro
http://www.jvb.periodikos.com.br/article/doi/10.1590/1677-5449.202400191
Jornal Vascular Brasileiro
Relato de Caso

Tratamento de endoleak tipo IIIa com seguimento de 7 anos: relato de caso

Treatment of type IIIa endoleak and 7-year follow-up: case report

Luiz Ronaldo Godinho Pereira; Keller Soares Ávila; Vinicius Oliveira Godoi; Leonardo Augusto D’Avila Gonçalves; Rafael Fortes; Marcelo Adriano de Assis Hudson; Daniel Mendes Pinto

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Resumo

O endoleak tipo III é caracterizado por um problema estrutural da endoprótese, como fratura da estrutura metálica, desconexão ou ruptura tecidual. Trata-se de uma complicação rara, ocorrendo em 2,1% dos pacientes após tratamento de aneurisma de aorta abdominal por reparo endovascular, com incidência maior em primeira e segunda gerações de endopróteses, podendo ocorrer precoce (após 30 dias) ou tardiamente. É dividido em IIIa – separação modular do componente – e IIIb – fratura da malha ou ruptura envolvendo a endoprótese. Este é um relato de caso de um paciente assintomático, previamente submetido à correção de aneurisma de aorta abdominal infrarrenal, que realizou uma tomografia computadorizada de seguimento, sendo encontrado um endoleak tipo IIIa com desconexão do corpo principal à extensão proximal. Uma nova abordagem endovascular terapêutica foi realizada para selamento do endoleak e correção aneurismática.

Palavras-chave

endoleak; aneurisma aórtico; diagnóstico por imagem

Abstract

Type III endoleaks are characterized by a problem with the endograft structure, such as fracture of the metallic structure, separation, or rupture. They constitute a rare complication, occurring in 2.1% of patients after treatment of abdominal aortic aneurysm by endovascular repair, with higher incidence in first and second generation endografts, and can occur early (after 30 days) or later. This type III classification is subdivided into IIIa –modular separation of components – and IIIb – mesh fracture or rupture involving the endograft. This case report describes an asymptomatic patient who had previously undergone infrarenal abdominal aortic aneurysm repair and underwent follow-up computed tomography which found a type IIIa endoleak with separation of the main body from the proximal extension. A second endovascular intervention was performed to seal the endoleak and correct the aneurysm.

Keywords

endoleak; aortic aneurysm; diagnostic imaging

Referências

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Submetido em:
20/06/2024

Aceito em:
06/04/2025

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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