Proximal iliac limb extension and embolization: a new technique of complete endovascular management of an unfavorably sited type III endoleak.

Type III endoleak is an uncommon but life-threatening complication of endovascular aortic repair, and such leaks at certain sites can be challenging to treat through an endovascular route. A 77-year-old man presented with severe abdominal pain and was found to have an abdominal aortic aneurysm with contained rupture due to an unfavorably cited type IIIb endoleak. He was successfully treated with an endovascular approach using bilateral iliac limb proximal extension combined with embolization of endoleak sac, endoleak site and the feeding recess, preserving flow through both the iliac limbs obviating the need for an additional femorofemoral bypass. The patient improved clinically and had a favorable long-term follow-up profile.