Presenter: Paola Scrivere

Affiliation: Udine Hospital and University, Italy

Abstract

This article describes a complex case of type IA endoleak and stent-graft migration post-EVAS, managed by staged hypogastric embolization and infrarenal endograft relining. Follow-up at 1 year confirmed aneurysm stabilization, demonstrating the efficacy of minimally invasive salvage strategies.

Introduction

Stent migration and endoleaks after EVAS require tailored approaches. This case highlights a two-stage endovascular solution for high-risk anatomical scenarios.

Case Study

An 84-year-old male presented with rapid aneurysm growth:

Imaging: Left CIA expanded from 34mm to 46mm with severe migration.

Stage 1: Prone-position gluteal access embolization of hypogastric aneurysm.

Stage 2: RLT endograft deployment to reline the infrarenal aorta.

Follow-up CTA showed complete exclusion without recurrence.

Conclusions

1.Staged embolization and relining balance safety and efficacy.

2.Infrarenal endografts address proximal fixation challenges.

3.Lifelong surveillance is critical for durability.