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Case Reports in Vascular Medicine
Volume 2017, Article ID 4931282, 5 pages
https://doi.org/10.1155/2017/4931282
Case Report

Early and Late Endograft Limb Proximal Migration with Resulting Type 1b Endoleak following an EVAR for Ruptured AAA

Division of Vascular and Endovascular Surgery, Stony Brook Medicine, Stony Brook, NY, USA

Correspondence should be addressed to Apostolos K. Tassiopoulos; ude.koorbynots@soluopoissat.solotsopa

Received 20 October 2016; Accepted 9 January 2017; Published 31 January 2017

Academic Editor: Jaw-Wen Chen

Copyright © 2017 Patrick T. Jasinski et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Seal zone failure after EVAR leads to type 1 endoleaks and increases the risk of delayed aortic rupture. Type 1b endoleaks, although rare, represent a true risk to the repair. Case Presentation. We report the case of a 65-year-old female who underwent emergent endovascular repair for a ruptured infrarenal abdominal aortic aneurysm and developed bilateral type 1b endoleaks following proximal migration of both endograft limbs. The right-side failure was diagnosed within 48 hours from the initial repair and the left side at the 1-year follow-up. Both sides were successfully treated with endovascular techniques. A review of the literature with an analysis of potential risk factors is also reported. Conclusion. For patients undergoing EVAR for ruptured AAA and with noncalcified iliac arteries, more aggressive oversizing of the iliac limbs is recommended to prevents distal seal zone failures.