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


METHODS
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.


CONCLUSIONS
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.
Ghanim
Karim
K
Vascular Surgery Department, Royal Perth Hospital, Perth, Australia. k.ghanim@hotmail.com
Mwipatayi
Bibombe P
BP
Abbas
Manzoor
M
Sieunarine
Kishore
K
D000368:Aged; D017130:Angioplasty; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D011475:Prosthesis Failure; D011859:Radiography; D015607:Stents