Case Report: Hidden danger of stiff guidewire retention: masking effect on distal sealing during EVAR

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Completion angiography is critical in verifying proper device deployment during endovascular aneurysm repair (EVAR).
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Retention of a stiff guidewire can lead to false-negative completion angiograms and misinterpretation of distal sealing adequacy.
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Type Ib endoleaks are concerning complications of EVAR, often requiring immediate correction or late reintervention.
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In this case, a retained guidewire contributed to a persistent type Ib endoleak, leading to further endovascular intervention.
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Follow-up imaging confirmed successful exclusion of the aneurysmal sac after additional repair, highlighting the importance of thorough intraoperative assessment.

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