An endurant ii stent graft system was implanted in a patient for the endovascular treatment the pre-operative rupture of an aortic fistula.It was noted that the aorto-gastric fistula was spitting up blood and this was a palliative procedure to prevent aortic rupture.It was reported that, during the index procedure, the physician asked that the patient not be intubated until after femoral access was gained.However, anesthesia did not wait and pressure dropped upon intubation.Percutaneous access was gained and a 12fr sheath was inserted.A reliant balloon was inserted and inflated.The physician stated that they would have preferred to remove the balloon prior to deployment of the stent graft, but thought that the patient may bleed out.The stent graft was deployed and pressure stabilized.During removal of the balloon, the balloon caught on the proximal edge of the stent graft and partially folded it back on itself.Imaging was done and determined there was no damage.It was noted the stent graft was ballooned and the rupture was sealed, resolving the event.No additional clinical sequelae were reported and it was noted that the patient would be going home to wait out the final days of unrelated end stage bladder cancer.
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