Endovascular repair of ruptured abdominal aortic aneurysm (REVAR) for Type I Endoleak Post open repair

A 69 year old gentleman with a background history of previous coronary artery bypass graft underwent open abdominal aortic aneurysm repair for a 9 cm symptomatic juxta renal aortic aneurysm with a 20 mm dacron graft 14 years ago. He had pneumonia and pseudomembranous colitis post operatively but recovered completely and was discharged home. He returned within 2-3 weekswith abdominal and back pain. MR angiogram showed contained rupture of the double breasted aortic sac post open repair with disruption of the anastomosis mimicking a type Ia and 1b endoleak and haematoma was noted to the superior and inferior part of the graft (Figure 1). An aortouni-iliac device Talent graft (World Medical, FL,USA) was deployed with a Talent occluder to the left common iliac artery and a right to left femoro-femoral bypass graft was performed with 8 mm dacron graft.