Abstract
An 86 year old man with a previous endovascular aortic repair presented with a type Ia endoleak five years after his intervention. Proximal extension with a custom made branched endograft with four inner branches was planned (E-xtra DESIGN MultiBranch; Jotec, Cryolife, Kennesaw, GA, USA). The 24 F graft was introduced using a through and through wire with significant resistance. (A) Upon retrieval of the introducer, there was complete avulsion of the left external iliac artery. (B) A 12 mm occlusion balloon was rapidly placed in the left iliac limb while the endovascular repair continued. Finally, an iliofemoral bypass was performed.Image 1
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