A rare case of stent graft-related endoleak during follow-up of aortic arch aneurysm F/B TEVAR.

A 68-year-old male patient was hospitalized with a giant arch aneurysm. Using 3D printing guidance, the aneurysm was successfully sealed, but post-surgery, he developed severe complications. He remained in the intensive care unit for 52 days for observation and was discharged for rehabilitation. During follow-up, recurrent blood in sputum prompted a computed tomography scan revealing intracavitary leakage. After multiple treatments and assessments, it was determined that type IV endoleak resulted from the proximal bare stent graft puncturing the membranous portion of the aortic stent. Subsequent stent graft procedures and precise embolization successfully closed the leakage, resolving the symptoms.