Explantation of fenestrated endograft complicated by complete junctional dissociation and symptomatic type IIIa endoleak

In this report, we present a 67-year-old man who was transferred from an outside facility with complaints of severe back pain. Computed tomography imaging demonstrated a type IIIa endoleak with complete junctional dissociation of his prior fenestrated endograft, between the visceral and the bifurcated components. Given the perpendicular configuration of the dissociated stent grafts, no endovascular salvage was feasible, and open explantation was indicated. His preoperative evaluation was significant for a positive cardiac stress test warranting coronary artery stenting. The patient underwent subsequent open graft explantation and aortic repair, and was ultimately discharged home after an uncomplicated hospital course.