Work

Multiple recurrence of type III endoleak due to junctional component uncoupling of the AFX2 endograft accompanied with continuous aneurysmal sac regression

Year: 2026

Type: article

Abstract: Junctional component uncoupling of an AFX endograft is a rare but catastrophic cause of late type IIIA endoleak after endovascular aortic repair. A 74-year-old man presented with abdominal pain and shock 2 years and 8 months after endovascular aortic repair with AFX2, despite progressive sac regression on surveillance imaging. Computed tomography revealed aneurysm rupture due to a massive type IIIA endoleak with proximal component uncoupling. Emergency relining was performed; however, recurrent type III endoleaks required conversion to an aortouni-iliac configuration with femoral-femoral bypass. Retrospective imaging demonstrated progressive proximal intercomponent angle and reduced component overlap, suggesting longitudinal aortic remodeling as a mechanism of uncoupling.

Source: Journal of Vascular Surgery Cases and Innovative Techniques

DOI: 10.1016/j.jvscit.2026.102522

Authors: Hiroki Tada, Akira Marumoto, Yu Yamada, Takashi Shintani, Teruya Nakamura

Institutions: Sakurabashi Watanabe Hospital, Nippon Life Hospital

Language: English

Topic: Aortic aneurysm repair treatments

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,250