The Nellix aneurysm sealing system aims at sealing the cavity of the sac of the aneurysm, to reduce typical complications such as migration or endoleak. We report on a case of a unique device-associated complication: rupture and displacement of the filling material into the aortic lumen, causing peripheral ischemia and imminent renal and visceral occlusion, in a patient with anastomotic ulcer after an open aortobiiliac bypass and calcified and tortuous iliac arteries. The material was removed by open surgery. The patient recovered completely. The device should be handled with great caution in cases with hostile access routes, and in secondary interventions.
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