Explanting the Nellix Endovascular Aortic Sealing Endoprosthesis for Proximal Aortic Neck Failure

Open conversion after endovascular aortic repair has inherent challenges particular to the device being explanted. The Nellix endograft is unlike any other device as it uses polymer filling of endobags within the aorto-iliac lumen to seal the abdominal aortic aneurysm (AAA) sac, a developing concept known as endovascular aneurysm sealing. Conversion to open repair of AAA treated with the Nellix endograft has rarely been discussed. Explants that have been previously reported were for graft infection. We present 2 Nellix graft explants that were required for device migration and subsequent development of a type IA endoleak. The technique and nuances observed during open conversion of this novel endograft for proximal aortic neck failure is described in this report.