Key result
Open surgical conversion resolves late type IIIb endoleaks following EVAR despite diagnostic imaging challenges.
Case Report (n=2)
No
Late type IIIb endoleaks can occur years after EVAR, are challenging to diagnose due to limited imaging sensitivity, and may require open surgical repair as a definitive treatment.
Long-term EVAR surveillance must account for possible late type IIIb endoleaks; leaves open optimal imaging and management strategies.
Endovascular aneurysm repair (EVAR) is a standard treatment for abdominal aortic aneurysms but is associated with late graft-related complications. Type IIIb endoleaks caused by graft fabric failure are rare and potentially fatal. We report two cases of late type IIIb endoleaks occurring 60 and 48 months after EVAR using Endurant and GORE® EXCLUDER® stent grafts, respectively. Diagnosis was challenging due to limited imaging sensitivity. Both cases highlight the persistent risk of late graft failure and underscore the continued role of open surgical repair as a definitive treatment option.
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Tayeh et al. (2026) conducted a case report in Abdominal aortic aneurysm (AAA) post-EVAR with late type IIIb endoleak (n=2). Open surgical conversion was evaluated on Successful management of type IIIb endoleak. Late type IIIb endoleaks occurring 48 and 60 months after EVAR were successfully managed with open surgical conversion after diagnostic imaging challenges.
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