Film evaluation summary: the exact cause of the events could not be determined from the single returned film.
A pre-implant sizing worksheet revealed that the patient had a severely angulated proximal neck measuring 25 mm in diameter, which was noted as mildly calcified.
A single returned still angiogram image during implant revealed that the endurant bifurcate was positioned ~5 mm below the visible right renal artery, and the infrarenal neck was angulated ~45 deg.
Contrast injection from above the level of the suprarenal stents showed a large amount of contrast near the right side of the bifurcate proximal margin, along the outer curvature, coming from a possible aortic perforation.
There may also have been a proximal type i endoleak.
Additional films during implant, including during the ballooning event, were not returned, and lack of ct¿s could not permit a more complete assessment of the patient¿s anatomy.
The angulated and calcified neck may have contributed to the proximal type i endoleak.
It is likely that the reported over ballooning within the diseased and angulated neck, may have led to the aortic rupture.
Per the physician¿s assessment the patient expired due to complications from the open procedure that followed the aortic perforation.
A good faith effort will be made to obtain the applicable information relevant to the report.
If information is provided in the future, a supplemental report will be issued.
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