Case Report: Hidden danger of stiff guidewire retention: masking effect on distal sealing during EVAR

Completion angiography is generally regarded as confirmation of a successful endovascular aneurysm repair (EVAR). However, this assumption may be misleading under certain circumstances. To our knowledge, there are no detailed reports describing EVAR failure caused by the retention of a stiff guidewire during the final angiogram. This technical oversight may contribute to a false impression of adequate distal sealing, potentially concealing a type Ib endoleak. By presenting this case, we aim to draw attention to this underrecognized intraoperative pitfall as one of the possible contributing factors, illustrate its imaging manifestations, and provide practical lessons for preventing similar complications in future EVAR reinterventions.