Type I endoleak after endovascular abdominal repair is associated with a high risk of aneurysm expansion and rupture. Though type I endoleak can frequently be managed with endovascular techniques, in this report we describe a patient whose endoleak was refractory to multiple attempts at endovascular repair. The patient ultimately underwent a novel minimally invasive surgical repair with placement of an aortic wrap around the infrarenal aortic neck, successfully abolishing the endoleak.

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