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Updated: Oct 26, 2026

Time-Resolved, Dynamic Computed Tomography Angiography for Characterization of Aortic Endoleaks and Treatment Guidance via 2D-3D Fusion-Imaging
Published on: December 9, 2021
Multiple recurrence of type III endoleak due to junctional component uncoupling of the AFX2 endograft accompanied
Hiroki Tada1, Akira Marumoto1, Yu Yamada2
1Department of Cardiovascular Surgery, Sakurabashi Watanabe Advanced Healthcare Hospital, Osaka, Japan.
Abstract:
Junctional component uncoupling of an AFX endograft is a rare but catastrophic cause of late type IIIA endoleak after endovascular aortic repair. A 74-year-old man presented with abdominal pain and shock 2 years and 8 months after endovascular aortic repair with AFX2, despite progressive sac regression on surveillance imaging. Computed tomography revealed aneurysm rupture due to a massive type IIIA endoleak with proximal component uncoupling. Emergency relining was performed; however, recurrent type III endoleaks required conversion to an aortouni-iliac configuration with femoral-femoral bypass. Retrospective imaging demonstrated progressive proximal intercomponent angle and reduced component overlap, suggesting longitudinal aortic remodeling as a mechanism of uncoupling.
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