Endovascular Salvage of Iliac Limb Maldeployment during EVAR Using a CODA Balloon and Bridging Stent: A Case Report

Iliac limb maldeployment during endovascular aneurysm repair (EVAR) is an uncommon but technically challenging complication. In this study, we present a case involving a patient with multiple comorbidities, including hypertension, hyperlipidemia, and coronary artery disease, who underwent EVAR for a progressively enlarging abdominal aortic aneurysm using the ALTO endograft. During the procedure, the right iliac limb was inadvertently deployed outside the contralateral gate into the aneurysm sac, resulting in maldeployment. This complication was successfully managed with endovascular salvage using a CODA balloon and a bridging stent graft. This case illustrates a variation of endovascular correction strategy adapted to the ALTO platform.