Hybrid repair of rare type IIIb endoleaks from an abdominal endograft: repeatedly undetected endoleaks.

We report a rare case of massive type IIIb endoleaks from an abdominal endograft, which were difficult to diagnose and required hybrid repair (including open surgery). The patient had previously undergone three catheter interventions for type Ia and II endoleaks after abdominal endografting. However, the abdominal aortic aneurysm gradually enlarged and required hybrid treatment (including an open repair), to successfully perform aneurysmorrhaphy and additional endograft insertions for the massive type IIIb endoleaks.