Successful Repair Using VALIANT Captivia for Type 1 Endoleak through a Fenestration on the Najuta Endograft in the Treatment of Distal Arch Aneurysm

Abstract

Endograft failure, especially type 1 endoleak, has remained a significant clinical concern and its treatment is often challenging. We report a case of type 1 endoleak after TEVAR using the Najuta prototype, which is a semi-custom-made pre-curved fenestrated device. The endoleak was successfully repaired by additional TEVAR using VALIANT Captivia. An 85-year old man with 70% of Japan Score (estimated early mortality rate) was admitted to our hospital owing to type 1 endoleak and enlargement of a distal arch aneurysm. He underwent zone 0 TEVAR using the Najuta prototype for the treatment of distal arch aneurysm at age 80. Computed tomography showed type 1 endoleak through a fenestration on the stent graft (SG) at age 83. So we performed re-intervention using VALIANT Captivia. This SG has proximal bare stent and strong radial force that may be effective for adequate seal of a space around a fenestration of the Najuta endograft. After this procedure, the endoleak disappeared.