Successful Percutaneous Closure of an Undiagnosed Patent Ductus Arteriosus Causing Type 2 Endoleak

Thoracic endovascular repair (TEVAR) is a valuable alternative to open surgical repair for aortic aneurysms, offering several benefits. However, one potential complication that demands attention is endoleak. This case report highlights a unique occurrence of type 2 endoleak, typically associated with aortic aneurysms treated by TEVAR, originating from an undiagnosed patent ductus arteriosus (PDA). The patient, a 68-year-old woman, underwent TEVAR for an aortic aneurysm complicated by underlying lung disease and pulmonary artery hypertension. During the procedure, an unexpected shunt between the aorta and the pulmonary artery was identified and subsequently revealed to be an undiagnosed PDA. Remarkably, the decision was made to continue with TEVAR while simultaneously deploying a stent graft to close the PDA. This case underscores the significance of comprehensive preprocedural aortic assessment and careful consideration of PDA closure to prevent type 2 endoleak in TEVAR, reinforcing the importance of thorough evaluation before such procedures.