Perigraft seroma (PGS) is a relatively rare complication of aortoiliac reconstructive surgery. We, herein, describe a case of a large PGS that was managed by using a hybrid technique of relining the original graft with simultaneous open drainage. An 86-year-old man with a 17.3-cm diameter PGS after prosthetic bifurcated graft replacement for abdominal aortic aneurysm was admitted to our hospital. He presented with abdominal distension and discomfort and had difficulty in taking food. The entire relining of the original covered stent graft with GORE ® EXCLUDER ® using aortic extension cuff and iliac extenders and simultaneous open evacuation of PGS were successfully performed. The symptoms of the patient totally improved, and no recurrence was detected at 2 years after the operation. This technique would be a feasible treatment option for this rare complication.
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