Upside-down and kissing stent graft techniques for late extravasation of a prosthetic graft implanted in the abdominal aorta.

Extravasation of prosthetic grafts is rare. Various anatomical problems after graft replacement might make standard endovascular treatment difficult. Use of a commercially available main body requires an adequate distance of the flow divider. An 86-year-old man developed extravasation of a graft that had been implanted in the infrarenal abdominal aorta 24 years previously. Endovascular repair with upside-down and kissing stent graft techniques using the contralateral leg was successfully performed.