Open Reintervention for Aneurysmal Sac Enlargement after EVAR.

We performed a late open reintervention for aneurysmal sac enlargement due to persistent type 2 endoleak (PT2EL) after EVAR for 8 of 286 patients. Surgical techniques are as follows: (1) The entire aneurysmal body was exposed. (2) All the aortic branched vessels were ligated. (3) The aneurysmal sac was opened followed by the performance of complete hemostasis. (4) An equine pericardium was wrapped and sutured to the aneurysmal sac to for reinforcement. This method is considered to be one of the feasible options for the treatment of aneurysmal sac re-enlargement after EVAR.