Embolization of a type 2 endoleak through catheterization of a hypogastric branched stent-graft

In contrast to internal iliac artery (IIA) occlusion, the use of branch stent-graft (BSG) has been developed as an efficient adjunct in preserving pelvic blood flow. However, the risk of post-procedural type 2 endoleak (EL) remains. We present the case of an 80-year-old man with a juxtarenal aneurysm extending to both common and IIA. The patient was treated with a fenestrated device and a left BSG after embolization of the right IIA branches. At 6 months, the persistence of a type 2 EL associated with aneurysm growth mandated EL embolization through the BSG with a good result. Technical issues are discussed.