[188752564]
Film evaluation summary: the reported endoleak seen during the interventional procedure was confirmed; however, the exact cause/source of the endoleak observed by the physician could not be determined from the films returned. Lack of films from the index procedure showing the endoleak did not allow assessment of the event prior to and post implantation of the endurant cuff. Lack of pre-implant ct? S did not allow for a thorough assessment of the pre-implant anatomy. Endoleak interrogation via selective angiograms (injecting from different levels within the stent graft) to help determine the source and rule out other potential endoleak sources was not seen, and only a single imaging view point (a-p) was observed in the films provided; thereby, making determination of the endoleak difficult. The reported type ia endoleak appears likely. The exact cause could not be determined but may have been related to the aortic neck angulation observed or due to other unknown neck anatomical issue(s). No obvious stent graft issues could be identified that could be a cause of a type ia endoleak. It is likely that an acute type iv blush endoleak caused by fabric porosity was also present. This likely type iv appeared as focused leak from the flow divider that is most likely due to the higher porosity in that portion of the stent graft distal to the overlap of the bifurcate and cuff. Other factors such as heparin dose, outflow resistance, imaging quality, and volume of the aneurysm sac may have also contributed to this likely type iv endoleak. Films from the reported aaa rupture event where the physician completed bilateral renal chimney stents and extended proximally with an endurant aortic cuff were not available for review. If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10