A Case of Rapid Aneurysm Expansion Requiring Open Surgery Six Months After Alto Endograft Deployment

Abstract

A 72-year-old male underwent endovascular aneurysm repair for an abdominal aortic aneurysm using the Alto endograft. Six months later, rapid aneurysm expansion due to a type II endoleak from the median sacral and lumbar arteries was observed. Endovascular treatment failed, necessitating open surgery with inflow artery ligation and aneurysm sac plication. Intraoperative findings revealed inflammation of the aneurysmal wall, and histopathological examination also showed infiltration of inflammatory cells. Seven months after reoperation, the patient remains free of complications.