Kwon J, et al. - Researchers sought to ascertain the long-term durability of the endovascular stent graft, and determine the complication rate from device failure due to material fatigue. Searching PubMed and Google Scholar, they identified 23 articles with 46 case reports of type IIIB endoleak from various Food and Drug Administration-approved stent-grafts following endovascular repair of infrarenal abdominal aortic aneurysm. Type IIIB endoleak most commonly occurred in the main body (34.8%), followed by the area of the flow divider (32.6%). Sixty-three percent (29/46) of cases showed sac growth. Following an average of 54.3 months after the index operation, endoleak diagnosis occurred. For elective repair of type IIIB endoleak, the primary approach undertaken was endovascular repair (61.3% vs 13.3%). Ruptured or symptomatic patients had higher perioperative mortality compared with patients undergoing elective repair (33.3% vs 6.5%). The data do not clarify the actual incidence of type IIIB endoleak and suggest multifactorial etiology in these cases. Therefore, they recommend appropriate imaging techniques and prompt intervention in suspicion of type IIIB endoleak to reduce the perioperative mortality rate.