Perioperative and mid-term results of trans-graft embolization of the hypogastric artery for treatment of type II endoleaks after endovascular aortic repair with off-label use of re-entry catheters

Type II endoleaks after endovascular aortic repair are a common scenario that, although infrequently, may sometimes require secondary interventions when leading to significant enlargement of the aneurysm sac. Herein, we present the perioperative and mid-term results of one of our endovascular aortic repair cases with type II endoleak from the hypo- gastric artery, whose ostium was covered by the prior stent graft limbs and that were successfully treated with a novel technique employing re-entry catheters in an off-label fashion. This technique may represent a valid alternative solution when conventional access between artery and prosthesis is laborious or impossible to achieve. (J Vasc Surg Cases Innov Tech 2025;11:101674.)