Translumbar repair of a type II endoleak associated with an aorta-to-left renal vein fistula after aortic stent-graft placement

An abdominal aortic aneurysm (AAA) is a serious medical condition with significant associated morbidity and mortality. Endograft repair of AAAs is a therapy in evolution, but offers promise as a minimally invasive treatment option. Persistent sac pressurization via endoleaks has limited wider application of stent-grafting technology. The present report describes a case of an AAA with rupture into a retroaortic left renal vein that was treated acutely with aortic stent-graft repair. Continued aneurysm enlargement and a large type II endoleak drained by an arteriovenous fistula were subsequently treated via a translumbar approach.