# The Degradation of Abdominal Aortic Prosthesis After 37 Years

## TL;DR

A man's abdominal aortic graft failed after 37 years, requiring intervention due to persistent leakage.

## Contribution

This case report documents a rare long-term failure of a synthetic graft used for aortic aneurysm repair.

## Key findings

- A synthetic graft failed after 37 years, leading to sac enlargement and endoleak.
- Placement of an EXCLUDER® stent graft resolved the endoleak and stabilized the condition.
- Long-term graft surveillance is critical even decades after initial implantation.

## Abstract

An 85-year-old man underwent abdominal aortic aneurysm (AAA) repair with a synthetic graft at age 48. Sac enlargement, likely due to an endoleak, was observed during follow-up, and covered stents were placed in the graft limbs at age 80. Despite this, the sac continued to enlarge, leading to a referral to our institution. Imaging revealed an endoleak from an uncovered graft section. An EXCLUDER® stent graft (W. L. Gore & Associates, Inc., Flagstaff, AZ) was placed to cover the graft entirely, resolving the endoleak. The patient was discharged on postoperative day 5. This case highlights the rare failure of a synthetic graft after 37 years.