Endovascular aneurysm repair (EVAR) surgery has become a more prevalent in recent years, as it is less invasive and requires a shorter hospital stay and recovery time, in addition to resulting in lower mortality. However, EVAR has the disadvantage of increased numbers of reintervention incidents, need of regular follow up, and uncertainty of long-term stability. Type II endoleak is the most common endoleak, but it mostly seals without intervention. Type I endoleak is a sealing failure around the graft and proximal neck or distal landing zone and usually occurs during the initial procedure, which can be corrected by ballooning, an additional stent (bare or graft), or surgery. Late type I endoleak can develop by migration of the graft or shrinkage or progression of aneurysm. Here we report a case of distal type I endoleak found 5 years after EVAR which was corrected by additional endovascular grafts.
Aneurysm ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal ; Endoleak ; Follow-Up Studies ; Length of Stay ; Neck ; Postoperative Complications ; Stents ; Transplants ; Uncertainty

PURPOSE: This paper compares a RSS (Rapid Streptococcal Screening) detection test with a throat culture. The RSS detection kit is an easier and faster way to identify the infection of Group A beta-hemolytic streptococcus (GABHS), the most common causal agent of acute bacterial pharyngitis. We also examine the clinical symptoms that are associated with bacterial pharyngitis. METHODS: A throat culture and a RSS detection test were performed simultaneously to all 239 patients who were suspected of having acute pharyngitis, and visited the emergency department between September 1st, 2002, and June 30th, 2003. Then the values of the RSS detection test were analyzed comparatively on a chi square test. The correlation between Centor criteria clinical features and bacterial pharyngitis was examined through a logic regression test. RESULTS: Comparative analysis of the results of a throat culture and RSS detection test showed a test sensitivity of 83.6%, specificity was 97.2%, and the kappa coefficient was 0.83 (95% C.I: 0.75~0.91). This suggests that the RSS detection test is valuable statistically. CONCLUSION: The RSS detection test is more accurate than the diagnosis of bacterial pharyngitis based on clinical features. Assuming that all patients with acute pharyngitis take antibiotics, an RSS detection test reduce of unnecessary antibiotics use.
Anti-Bacterial Agents ; Emergencies ; Humans ; Logic ; Pharyngitis ; Pharynx ; Sensitivity and Specificity ; Streptococcal Infections ; Streptococcus