Purpose : To report the use of a endograft to manage a type IB endoleak in a patient with a juxtarenal aortic aneurysm previously treated with a multylayer stent CASE REPORT: Under compassionate use a 68 years old patient with a juxtarenal aortic aneurysm and multiple comorbidities was treated with a multilayer flow modulating stent. Twelve months later a new CT scan identified a type Ib endoleak with an increase of the aortic aneurysm size due to extension of the aneurysmal disease to the aortic carrefour . A new endovascular procedure was then performed , deploying an aorto bisiliac endoprosthesis . After 18 months serial echocolor duplex and CT scans have shown normal visceral arteries patency, no signs of endoleak and sac shrinkage of 5 mm CONCLUSION: In this case, MARS failed to treat the AAA and required a reoperation with conventional covered stentgraft for distal sealing, which may be considered a feasible solution to manage potential endoleak
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