Does Sac Size Matter? Findings Based on Surgical Exploration of Excluded Abdominal Aortic Aneurysms

Abstract

The authors examined outcomes of excluded abdominal aortic aneurysms in 15 patients whose abdomina: aortic aneurysms (AAA) continued to expand after exlusion, but without evidence of endoleak. The aneurysm sacs were evaluated with computed tomography and diagnostic ultrasonography. Endoleak was demonstrated in 8 patients, who underwent coil embolization. Those patients without demonstrabie endoleak (n = 7) underwent surgical exploration and sac endoaneurys morrhaphy. Examination of the sac revealed yellow, fibrinous material with clear serous fluid, or liquified thrombus with serosanguinous fluid. The authors concluded that causes other than missed endoleak can account for continued expansion of excluded AAA sacs and question the need for surgical exploration of patients with expanding AMA sacs when there is no evidence of high sac pressure or endoleak.