Endovascular Aneurysm Repair for a Sac Enlargement Caused by Type IIIb Endoleak Diagnosed Using Four-Dimensional Computed Tomography.
Satoru Tomita, Kenta Masada, Kazufumi Yoshida et al.
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Case in brief
A 75-year-old man presented with gradual enlargement of an abdominal aortic aneurysm sac, which reached 55 mm, 13 years after EVAR. Although he had been free of aortic events for 10 years after the procedure, contrast-enhanced CT later showed an endoleak but could not distinguish type II from type III. Four-dimensional CT identified a type IIIb endoleak. Relining EVAR was performed, and postoperative contrast-enhanced CT showed that the endoleak had resolved.
What made this case unusual
Conventional contrast-enhanced CT detected the endoleak but could not classify it; four-dimensional CT enabled a definitive diagnosis of type IIIb.
Diagnostic / clinical pearl
When an endoleak is seen on conventional CT but its type remains uncertain, four-dimensional CT may help identify a type IIIb endoleak.