Late aneurysm rupture after repressurization of a thrombosed stent-graft.

Objective: To report late abdominal aortic aneurysm (AAA) rupture after endovascular stent-graft repair despite complete thrombotic stent-graft occlusion.

Methods: A 65-year-old man underwent successful endovascular aneurysm repair (EVAR) with a Stentor device in 1995. In the interim course, the patient developed complete thrombotic stent-graft occlusion, which was treated with an axillobifemoral bypass. After 8 years, the patient presented with a reperfused and ruptured infrarenal AAA. Open repair was performed, with a good clinical result and exclusion of the AAA.

Conclusions: Thrombosed stent-grafts and aneurysms can transmit systemic arterial pressure and cause late rupture. Lifelong surveillance is mandatory in EVAR patients.