FRCS Vascular Surgery Practice Questions - Intercollegiate Specialty Fellowship Examination In Vascular Surgery (FRCS Vasc) Exam

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A 68-year-old woman undergoes surveillance CT after EVAR. The sac has enlarged by 8 mm over 12 months. Imaging shows contrast within the aneurysm sac fed retrogradely by a patent inferior mesenteric artery and lumbar vessels, with no graft junctional defect. What is the most appropriate next step for this persistent sac-enlarging endoleak?

Immediate open conversion and graft explantation Proximal cuff extension at the aortic neck Reassurance and routine annual surveillance only Embolisation of the feeding vessels / sac (e.g. coil or glue embolisation)

Correct Answer:

Embolisation of the feeding vessels / sac (e.g. coil or glue embolisation)

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