title: Endovascular management of type Ib endoleak complicating a juxtarenal aortic aneurysm previously treated with a multilayer stent.
abstract: BACKGROUND
  To report the use of an endograft to manage a type Ib endoleak in a patient with a juxtarenal aortic aneurysm previously treated with a multilayer stent.
  
  
  METHODS
  Under compassionate use, a 68-year-old patient with a juxtarenal aortic aneurysm and multiple comorbidities was treated with a multilayer flow modulating stent. Twelve months later a new computed tomography (CT) scan identified a type Ib endoleak with an increase in the aortic aneurysm size because of the extension of the aneurysmal disease to the aortic carrefour. A new endovascular procedure was then performed, deploying an aorto-biiliac endoprosthesis. After 18 months, serial echocolor duplex and CT scans have shown normal visceral arteries patency, no signs of endoleak, and sac shrinkage of 5 mm.
  
  
  CONCLUSIONS
  In this case, the Multilayer Aneurysm Repair System failed to treat the abdominal aortic aneurysm and required a reoperation with conventional-covered stent graft for distal sealing, which may be considered a feasible solution to manage potential endoleaks.
authors.affiliation: Vascular Surgery Unit, University of Bari, Bari, Italy. Electronic address: domenico.angiletta@uniba.it.
authors.forename: Domenico
authors.initials: D
authors.lastname: Angiletta
authors.affiliation: Vascular Surgery Unit, University of Bari, Bari, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Maiellaro
authors.affiliation: Vascular Surgery Unit, University of Bari, Bari, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Marinazzo
authors.affiliation: Vascular Surgery Unit, University of Bari, Bari, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Wiesel
authors.affiliation: Vascular Surgery Unit, University of Florence, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Pulli
authors.affiliation: Vascular Surgery Unit, University of Bari, Bari, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Regina
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D057867:Endoleak / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D057510:Endovascular Procedures; D006801:Humans; D008297:Male; D015607:Stents; D014057:Tomography, X-Ray Computed