Occlusion of endovascular stent-graft for abdominal aortic aneurysm three years after surgery

A 79-year old man was admitted to our department with complaints of bilateral foot coldness, numbness and intermittent claudication. He underwent endovascular repair for abdominal aortic aneurysm three years before. An abdominal X-ray showed highly kinked endovascular stent-graft which indicated graft migration, and aortography showed occlusion of stent-graft and infrarenal aorta. An axillo-bifemoral bypass was performed and blood flow to the lower extremities was restored. Endovascular repair for AAA has been established worldwide as a less invasive treatment. Endovascular repair can be performed with low mortality and morbidity in the short period, however, in the long-term follow-up series, several late complications, such as late endoleaks, graft occlusion, AAA expansion, and even AAA rupture were encountered. Indication for endovascular repair for AAA still remains controversial because of these late complications, therefore, great attention must be paid for patient selection for endovascular repair.