We report the explant of an infrarenal aortic endograft previously placed to exclude an abdominal aortic aneurysm (AAA).

A 74 year old male with a 7.5 cm AAA underwent endovascular repair with a bifurcated Ancure graft in 2000. Over the course of two years his AAA enlarged to 9.5 cm. Angiography demonstrated a type I and type II endoleak. The type I was treated with an Aneuryx extender cuff and the type II with endovascular coiling. All further CT scans and angiograms failed to show evidence of persistent endoleaks. However, over the next 18 moinths, his AAA increased to 10 cm necessitating an open operation with explantation of the endograft. Intraoperative analysis of the explanted endograft demonstrated an intact endograft with no evidence of endoleak. Fibrous ingrowth was identified at the proximal and distal attachment sites. The explant was successfully completed with a Dacron interposition graft.

Endovascular therapy has dramatically changed the treatment options for patients with AAAs. With this modern therapeutic modality comes new treatments for endovascular problems. Familiarity with endograft explantation will be a needed tool in the vascular surgeon's armamentarium.