Endovascular aneurysm repair

Case contributed by Odai Bahjat Al-Jaabari

Presentation

Abdominal pain, tachycardia, and hypotension.

Patient Data

Age: 75 years
Gender: Male
dsa

The DSA shows a large infra-renal abdominal aortic aneurysm.

The sheath and catheter were advanced from the bilateral femoral arteries.

The 2nd and 3rd images show endoleak type 1A (inadequate seal at the proximal and distal end of a stent graft) and this was treated by ballooning.

Case Discussion

An abdominal aortic aneurysm is a very common finding in CT scans, and rupture is the most life-threatening complication with a high mortality rate.

It is considered a cardiovascular emergency associated with 30-days mortality as high as 70%.

Balloon occlusion and endovascular repair (EVAR) in patients with feasible anatomy are recommended in order to reduce mortality.

The procedure was done under local anesthesia and sedation because the patient vital signs were unstable. 

The procedure was mainly carried out through the right common femoral sheath, however, a second approach was through the left common femoral artery.

During the procedure, he had grade one A endoleak and was treated by balloon catheterization. Successful bilateral common iliac arteries stent insertion post-procedure.

An endoleak is a common complication of EVAR, mostly happening during the procedure.

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