Abstract
An 88-year-old male was treated with endovascular repair of an abdominal aortic aneurysm using Gore Excluder stent-graft. Two years after the procedure, the patient was referred to our emergency room due to abdominal pain. Computed tomography revealed an enlargement of the abdominal aortic aneurysm and a type Ia endoleak located left posteriorly on the bifurcated stent-graft. The patient was diagnosed with impending rupture of aneurysm, and underwent delayed open surgical conversion. The proximal and distal component of the stent-graft was preserved with stent-graft cross-clamping and partial stent-graft removal. Aortic reconstruction was performed with an end-to-end anastomosis between a bifurcated graft and the preserved stent-graft. Computed tomography after the delayed open surgical conversion demonstrated neither disruption nor collapse of the preserved stent-graft. The partial removal of the stent-graft avoiding suprarenal aortic cross clamping appears to be safe and effective.
