title: A Rare Complication After Endovascular Aneurysm Repair: Disconnection of the Suprarenal Stent of a Zenith Endograft.
abstract: OBJECTIVE
  To report a disconnection between the bare suprarenal stent and the main body of a Zenith endograft.
  
  
  METHODS
  A 79-year-old man with a history of successful endovascular repair of an aortic aneurysm presented a sudden episode of hypotension and hematuria. He had undergone implantation of a Zenith bifurcated device 8 years earlier in 2006. Plain abdominal radiography and computed tomography showed disconnection of the uncovered proximal stent, which led to endograft migration and type Ia endoleak. The patient also presented with distal endoleaks at the attachment sites in both common iliac arteries. The aneurysm sac diameter had increased from 52 to 96 mm. A proximal aortic cuff and bilateral iliac extensions were deployed via a common femoral artery access. Completion angiography did not show endoleak.
  
  
  CONCLUSIONS
  After publication of a few such cases with the older Zenith device, the union between the suprarenal stent and main body was reinforced in 2002 to prevent this complication. Since modification of the device, this sequela had not been described. The reappearance of this complication underscores the need for continued surveillance, considering that these late events may require a reintervention to maintain the clinical success of the procedure.
authors.affiliation: Department of Angiology, Endovascular and Vascular Surgery, Hospital Universitario Dr. Peset, Valencia, Spain atorres658@yahoo.es.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Torres-Blanco
authors.affiliation: Department of Angiology, Endovascular and Vascular Surgery, Hospital Universitario Dr. Peset, Valencia, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Molina-Nácher
authors.affiliation: Department of Angiology, Endovascular and Vascular Surgery, Hospital Universitario Dr. Peset, Valencia, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Sala-Almonacil
authors.affiliation: Department of Angiology, Endovascular and Vascular Surgery, Hospital Universitario Dr. Peset, Valencia, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Ortiz-Monzón
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D000072226:Computed Tomography Angiography; D057867:Endoleak / Q000209:etiology / Q000601:surgery; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005547:Foreign Bodies / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D015607:Stents; D013536:Suture Techniques; D016896:Treatment Outcome
keywords: abdominal aortic aneurysm; complication; endograft; endoleak; endovascular aneurysm repair; migration; stent disconnection; stent-graft