Key result
TREO stent-graft relining successfully resolves type 3b endoleak four years after initial EVAR.
Why the study?
Late postoperative type 3 endoleaks associated with the AFX stent-graft are commonly reported and present treatment challenges.
Case Report (n=1)
No
The TREO stent-graft appears to be a viable option for relining the AFX stent-graft in cases of type 3b endoleak.
Supports feasibility of TREO relining for AFX type 3b endoleak; hypothesis-generating and should not yet change practice.
Late postoperative type 3 endoleaks associated with the AFX (Endologix, Irvine, CA, USA) stent-graft are commonly reported. The AFX's endoskeletal design raises concerns about wire entrapment between its frame and fabric, as well as a risk of type 1a endoleak. An 84-year-old man with prior EVAR using the AFX presented with a type 3b endoleak 4 years postoperatively. He underwent relining with the TREO stent-graft (Terumo Aortic, Sunrise, FL, USA), which enabled easy contralateral gate cannulation and secured a long proximal landing zone. The TREO appears to be a viable option for relining the AFX in type 3b endoleak cases.
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Nita et al. (2025) conducted a case report in Type 3b endoleak after EVAR (n=1). Relining with TREO stent-graft was evaluated on Disappearance of endoleak. Relining with the TREO stent-graft successfully treated a type 3b endoleak 4 years after initial EVAR with an AFX device, with no residual endoleak observed on postoperative day 5.
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