Dynamic CTA image guidance for targeted robotic ligation of type II aortic endoleak

Type II endoleaks are frequent after endovascular aortic repair, and recurrent endovascular failures may require open repair with high morbidity. We report a 73-year-old patient with a persistent type II endoleak managed by targeted robot-assisted retroperitoneal ligation of lumbar arteries. Dynamic computed tomography-based three-dimensional reconstructions of target vessels provided intraoperative navigation, enabling precise localization through a minimally invasive robotic approach, while minimizing procedural complications and effective management. This case demonstrates the feasibility of combining advanced imaging and robotic technology, highlighting the potential advantages of image-guided robotic surgery for complex vascular pathologies requiring innovative, definite treatment options.