Primary Endovascular Treatment of Late-Onset Type 3 Endovascular Aortic Repair Rupture Using the Endurant II Stent Graft and Rapid Response Protocol

The objective of this article is to describe a patient with hemorrhagic shock due to type 3 post-endovascular aortic repair rupture successfully treated with the endurant II stent graft via a primary endovascular approach with a rapid response protocol. A 65-year-old male patient who underwent endovascular aortic repair 3 years ago was admitted to the emergency department with severe abdominal pain and hemorrhagic shock. The patient was rapidly taken to the angiography laboratory, and aortography demonstrated distal aortic graft rupture and extravasation of contrast media. The repair was performed successfully with 3 stent-grafts by paying attention to rupture localization and renal artery ostia. The hemodynamics of the patient improved very quickly, and the patient was discharged after 5 days. Emergency primary stent grafting using a rapid response protocol could be a crucial alternative to open surgery for late endoleaks, which are complicated with hemorrhagic shock.