Endovascular aneurysm repair (EVAR) is first-choice treatment for many patients with abdominal aortic aneurysms. Complications unique to endovascular treatment include endoleak and endotension, which can eventually lead to rupture. We present two cases of late aortic rupture after EVAR, where both patients had recent preceding catheter-directed thrombolysis with urokinase for acute limb ischemia. These cases suggest a relation between thrombolytic therapy and aortic rupture after EVAR, and we should therefore be aware of this possible complication.

AAA, Endoleak, Endotension, EVAR, Urokinase
dx.doi.org/10.1007/s00270-017-1671-8, hdl.handle.net/1765/108293
CardioVascular and Interventional Radiology
Erasmus MC: University Medical Center Rotterdam

Sudiono, D.R. (Davy R.), Hoencamp, R. (Rigo), Ottevanger, J. (Jaap), Eefting, D, & van der Linden, E. (2017). Aortic Aneurysm Rupture After Urokinase Treatment for Acute Limb Ischemia in Two Patients After EVAR. CardioVascular and Interventional Radiology, 40(10), 1641–1644. doi:10.1007/s00270-017-1671-8