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Hydroxocobalamin (Cyanokit , Meridian Medical Technologies, Columbia, MD, USA), a form of vitamin B12 conventionally used to treat cyanide poisoning, has recently been described as an off-label treatment for vasoplegic syndrome because it inhibits nitric oxide synthase and binds nitric oxide directly.1 An 82-yr-old man underwent open explantation of an abdominal aortic stent graft with replacement