J Korean Surg Soc.  2009 Dec;77(6):429-433. 10.4174/jkss.2009.77.6.429.

Successful Endovascular Aneurysm Repair for a Ruptured Abdominal Aortic Aneurysm

• Kim JY
• Park KM
• Jeon YS
• Cho SG
• Hong KC

• KMID: 1464824
• DOI: http://doi.org/10.4174/jkss.2009.77.6.429

Abstract

Endovascular aneurysm repairs for a ruptured AAA (EVAR for r-AAA) have been reported with limited results although endovascular aneurysm repairs for elective AAA (EVAR for e-AAA) have shown good early and late results. In this case report, the authors described successful EVAR for r-AAA. A 93-year-old female underwent emergent EVAR for r-AAA. An aortic occlusion balloon was inserted before general anesthesia for hemodynamic stability. Zenith endograft was deployed under general anesthesia. Completion angiography showed no endoleak but there was coverage of the right renal artery. She was discharged 2 weeks after overcoming transient acute renal insufficiency. We concluded that EVAR for r-AAA can be an alternative option for the treatment of ruptured AAA.

Keyword

Abdominal aortic aneurysm; Rupture; Endovascular treatment; Stent; Stent graft

MeSH Terms

Acute Kidney Injury
Anesthesia, General
Aneurysm
Angiography
Aortic Aneurysm, Abdominal
Endoleak
Female
Hemodynamics
Humans
Renal Artery
Rupture
Stents

Figure

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  Fig. 1 CT images from the referral center showed retroperitoneal rupture from abdominal aortic aneurysm (AAA) (A), AAA of 65×59 mm in diameter (B) and aortic neck of 21 mm in diameter (C).

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  Fig. 2 Before general anesthesia, aortic occlusion balloon (Coda Balloon) was inserted by femoral approach.

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  Fig. 3 Occluded limbs of stent graft were thrombectomized using thrombectomy over wire catheter.

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  Fig. 4 Completion angiography showed coverage of right renal artery, and no endoleak.

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  Fig. 5 Following CT after EVAR showed no endoleak, reduced retroperitoneal hematomaand patent endograft (A, B). But, renal infarction with partial renal arterial flow in right kidney was observed (C).

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