Presenter: Ainitze Ugartemendia Iturrizar

Affiliation: Hospital Universitario Donostia, Spain

Abstract

This article presents a case of type IIlc endoleak post-BEVAR, managed by drilling through the existing stent fabric and relining with a new bridging stent. Follow-up at 1 year confirmed endoleak resolution and SMA patency.

Introduction

Type IIlc endoleaks (stent-branch misalignment) pose significant challenges. This case demonstrates a novel reintervention strategy via brachial access.

Case Study

A patient with acute aortic syndrome 5 years post-BEVAR:

Diagnosis: CTA revealed type IIlc endoleak.

Intervention: Astato XS 20 wire drilled through the stent, followed by Bentley Regrat+ deployment.

Outcome: Endoleak sealed, SMA flow restored.

No recurrence at 1-year follow-up.

Conclusions

1.Fabric penetration enables complex endoleak repair.

2.Long-term surveillance detects stent migration risks.

3.Multidisciplinary teams enhance outcomes in reinterventions.