PURPOSE: To describe the endovascular treatment of intra-abdominal perigraft seromas associated with small-caliber expanded polytetrafluoroethylene (ePTFE) grafts. CASE REPORTS: Two patients who underwent hybrid repair of thoracoabdominal aortic aneurysms in which renovisceral bypass grafts were implanted presented with large, symptomatic perigraft seromas. The 5-to 8-mm-diameter ePTFE bypass grafts believed to be involved in the seromas were successfully relined with self-expanding Viabahn stent-grafts in percutaneous procedures. The patients' symptoms were relieved, and imaging follow-up (18 and 10 months, respectively) has shown near complete resorption of the seromas. CON-CLUSION: It is expected that this minimally invasive technique could be very valuable in treating aortic, renovisceral, and peripheral perigraft seroma.

inflation inside the previously placed stent is used to confirm contralateral communication (figure 1). Results Coil embolization from the contralateral circulation with ipsilateral angiography results in occlusion of the recurrence (figure 2). Conclusions The Circle of Willis may increase the risk of aneurysm recurrence on flow diverted segments. That being said, it provides a valuable path through which future access to treated aneurysms can be gained. Aneurysm coiling from the contralateral circulation is possible after flow diversion.