Late stent-graft migration secondary to separation of the uncovered segment from the main body of a Zenith endoluminal graft

PURPOSE: To report a case of type I endoleak secondary to complete disruption of the sutures uniting the uncovered and covered segments of a bifurcated Zenith endoluminal graft, causing displacement and distal migration of the graft main body.

CASE REPORT: A 76-year-old man had successful exclusion of an abdominal aortic aneurysm with a Zenith endoluminal graft in 1999. He continued to do well until the 4-year surveillance imaging [computed tomography (CT) and plain abdominal radiography] showed device migration and proximal endoleak, with consequent expansion of the aneurysm. A proximal extension stent-graft was inserted with good seal. The 1-month follow-up CT angiogram showed reduced aneurysm size and no evidence of any leak.

CONCLUSION: This case shows that the failure of an endoluminal graft occurs at weak points in the construction of the graft, reinforcing the need for long-term surveillance. If detected promptly, such events can often be treated by another endovascular procedure.