An endurant ii stent graft system was implanted in a patient for the endovascular treatment of a 50 mm in diameter abdominal aortic aneurysm.It was reported that after implant of the bifurcate stent graft and the contralateral limb the physician performed a kissing ballooning procedure with two reliant balloons.At the angiographic control an endoleak was observed, there was a type iii endoleak as the guidewire was able to be passed through the stent graft.The physician implanted an additional endurant limb within the ipsilateral leg of the bifurcate to cover the hole, but the angiographic control still shows the presence of the endoleak, however, smaller compared to the initial situation.The physician finally decided to extend up to the bifurcation with an endurant stent graft.At the final angiography the endoleak was later but still unresolved.It is possible that the bifurcate may have been damaged during the kissing balloon procedure, due to the calcium presence.A 20 cc syringe was used to inflated the balloons with 50% contrast and 50% saline solution.It is unknown how much fluid was injected.The balloon was inflated once in each position from the proximal neck down to the distal landing zone, always inside the graft fabric.The physician ballooned with normal pressure.The patient will be monitored.No additional clinical sequelae were reported and the patient is fine.
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