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Endovascular repair for acute symptomatic and ruptured abdominal aortic aneurysms.

Ulster Medical Society
Publication Date
  • Research Article


The Ulster Medical Journal, Volume 70, No. 1, pp. 51-53, May 2001. Case Report Endovascular repair for acute symptomatic and ruptured abdominal aortic aneurysms S P Junnarkar, J Reid, L C Johnston, B Lee, R J Hannon, C V Soong Accepted 7 April 2001 Since the introduction of endovascular repair of abdominal aortic aneurysm, an increasing proportion ofelective asymptomatic patients have been found to be suitable for endovascular repair despite uncertainties over long-term durability and cost benefit. However, one group of patients whose recovery would most likely be improved and in whom postoperative hospital stay would be reduced by this technique are those who present with an acutely symptomatic or leaking abdominal aortic aneurysm. Conventional urgent and .. ~ ~~ ~ ~~~~ ~~~~~~~~~~~~~~~~~~~........... ...~ ~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~. ......;....... .. . Fig 1. Diagrammatic representation of insertion of stent graft (Zenith device (William Cook Europe A/S, Bjaeverskov, Denmark)). emergency open repair of these patients are associated with significant mortality rates of approximately 20% and50% respectively.1 Those who survive may have a protracted recovery, requiring prolonged management in an intensive care unit. The endovascular technique avoids an abdominal incision and involves the intraluminal placement of stem-grafts via surgically exposed femoral arteries. The graft, which is preloaded in a plastic sheath, is advanced over guidewires up the femoral arteries until it is immediately distal to the lower of the two renal arteries. Once in position, the graft is released from the sheath and extensions into the iliac arteries are then attached to the main body of the graft through additional delivery sheaths (Figure 1). The stem-grafts are self- expanding and will fill to exclude the aneurysm. Here we report three patients, who presented with acute symptomatic infrarenal abdominal aortic aneurysms, one of which was confirmed to have a contained leak on CT scan. CASE REPORT T

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