Iliac Relining over a Brachiofemoral Pullthrough Wire to Seal a Type IIIa Endoleak after EVAR for Aorto-iliac Aneurysms

Introduction An endovascular solution to treating type IIIa endoleaks with component misalignment is presented. Case report A 68-year-old male presented with an enlarging 10 cm left common iliac artery aneurysm due to a type IIIa endoleak. Component gaps were successfully bridged by relining the left iliac circuit with new limbs deployed over a brachiofemoral pull-through wire. Discussion Type IIIa endoleaks may be not straightforward to repair if limb components are misaligned. A planned pullthrough wire allows for component re-alignment and successful treatment of this complication.