Abdominal aortic aneurysm rupture following endoluminal graft deployment: Report of a predictable event

Purpose: To describe the predictability of an abdominal aortic aneurysm (AA A) rupture secondary to a type II endoleak following stent-graft exclusion. Methods and Results: An 81-year-old man with an enlarging AAA underwent end ovascular repair using an AneuRx aortic stent-graft, but a type II endoleak fed by an accessory renal artery was detected at postprocedural computed t omography (CT). Surveillance CT scans at 6 and 16 months showed an increase in the aneurysm diameter and endoleak volume, but the patient refused advi sed treatment to close the leak. He suffered a fatal aneurysm rupture 24 mo nths after endografting. Retrospective analysis of CT data documented progr essive aneurysm enlargement that correctly predicted the rupture. Conclusions: Type II endoleaks can lead to aneurysm rupture. Three-dimensio nal (3D) spiral CT angiography offers an opportunity to track endoleak volu me and the effect of exposure to systemic pressure on the aneurysm sac.