Management of type 1A endoleaks can be challenging. In the endovascular era, this condition is expected to become more frequent. Conventionally, surgical explant of the endograft remains the "last-resort" surgical treatment when all endovascular or other open options are exhausted. Endograft removal is a difficult and morbid procedure. An alternative technique is described that involves cinching the endograft after disengagement of the proximal fixation hooks. The endograft is redeployed within a prosthetic aortic replacement graft with an overlapping zone. This can reduce complications such as from additional anastomoses, graft bleeding, prolonged clamping, operative time, and associated comorbidities.
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