Iatrogenic Ureteral Injury during Translumbar Embolization of a Type II Endoleak

The persistence of flow within an aneurysm sac remains the so-called Achilles heel of endovascular aortic aneurysm repair. The management of type II endoleaks remains controversial, although aneurysm sac expansion is an accepted indication for intervention. The present case describes a patient with a type II endoleak following endovascular repair of an abdominal aortic aneurysm treated by translumbar embolization. The procedure was complicated by iatrogenic injury to the left ureter and nontarget embolization resulting in acute ureteral obstruction.