An alternative approach for treating a type Ia endoleak after conventional EVAR using the Nellix endovascular aneurysm sealing

Abstract PURPOSE: To report the use of a Nellix endovascular aneurysm sealing (EVAS) device, to successfully treat a type Ia endoleak after an endovascular aortic repair (EVAR). CASE REPORT: A 70-years old man was diagnosed with a 90-mm aortic aneurysm, suspicious for being inflammatory. It was initially treated successfully, with a Medtronic Endurant (Medtronic, Minneapolis, MN). Five years after the index endovascular repair, an asymptomatic type Ia endoleak was detected on duplex ultrasound and computed tomographic angiogram. Other endovascular solutions in the form of proximal cuff, chimney was considered difficult to execute due to challenges in planning, manipulation, and renal cannulation caused by the short proximal sealing zone above the existing stent-graft and the constraints of the previous endograft Thus, a relining of the previous endoprothesis was performed using the Nellix system (Endologix, Inc., Irvine, CA). One-year follow-up imaging demonstrated successful resolution of the endoleak and persistent sealing of the Nellix device. CONCLUSION: Nellix Endovascular Aneurysm Sealing system can be an alternative and safe option for relining a stent-graft with a type Ia endoleak. Nellix platform may can be added to the clinician's armamentarium for treating type Ia endoleak after conventional EVAR of infrarenal AAA.