Incomplete Excluder Limb Graft Deployment: Cause and Solution

The Excluder stent graft (W.L. Gore and Associates, Flagstaff, AZ) is one of the most frequently used devices for endovascular abdominal aortic aneurysm repair and offers the advantage of a simple and reliable deployment mechanism. We report an unexpected complication during deployment of an Excluder limb graft; the “rip cord” deployment system broke during pulling, most probably because of interference with a previously placed common iliac artery stent, thereby resulting in incomplete graft deployment. This report notes that problems may rarely arise when deploying an Excluder limb graft within already stented iliac arteries and provides technical considerations to manage such events successfully.