Unusual Case of AneuRx Stent-Graft Failure Two Years after AAA Exclusion

Purpose: To present a case of type-III endoleak due to separation of modular components and suture breakage after abdominal aortic aneurysm (AAA) repair with the AneuRx stent-graft. Case Report: A 58-year-old man with a 78-mm AAA underwent successful aneurysm exclusion with an AneuRx stent-graft in 1998. Because the bifurcated component migrated during deployment, an additional aortic cuff was deployed to extend the stent-graft proximally to just below the renal arteries. On routine evaluation with computed tomography at 2 years postimplantation, a type-III endoleak with anterior displacement of the stent-graft was discovered. Angiography revealed separation of the aortic cuff from the stent-graft body. The aneurysm, which had decreased to 70 mm at 6 months, had enlarged to 80 mm in diameter. The patient underwent surgical AAA repair with removal of the stent-graft. Macroscopic examination showed suture breakage and separation of the stent rings and the graft material. Conclusions: This late complication of the AneuRx endograft underscores the need for frequent imaging surveillance in all patients undergoing endoluminal AAA repair.