Δημοσίευση

Chronic contained abdominal aortic aneurysm rupture after suprarenal fixation fatigue fracture.

ΤίτλοςChronic contained abdominal aortic aneurysm rupture after suprarenal fixation fatigue fracture.
Publication TypeJournal Article
Year of Publication2012
AuthorsPitoulias, G. A., Mavros D. M., Pappas E. A., Atmatzidis S. K., & Papadimitriou D. K.
JournalAnn Vasc Surg
Volume26
Issue7
Pagination1011.e7-1011.e10
Date Published2012 Oct
ISSN1615-5947
Λέξεις κλειδιάAbdominal Pain, Aged, 80 and over, Aortic Aneurysm, Abdominal, Aortic Rupture, Aortography, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation, Chronic Disease, Endoleak, Endovascular Procedures, Foreign-Body Migration, Hemodynamics, Humans, Male, Predictive Value of Tests, Prosthesis Design, Prosthesis Failure, Reoperation, Stents, Tomography, X-Ray Computed, Treatment Outcome
Abstract

Chronic contained rupture (CCR) of an abdominal aortic aneurysm is a rare condition, and differential diagnosis might be difficult. We present a clinical case of a hemodynamically stable octogenarian who presented with intermittent pain in the left lower abdomen. The patient had a history of diverticulitis, and 6 years ago, he had undergone endovascular abdominal aortic aneurysm repair (EVAR) with a Talent bifurcated prosthesis. Additionally, 20 days before his admission to our hospital, he had undergone a secondary iliac limb extension for treatment of post-EVAR rupture. On admission, abdominal plain radiography identified suprarenal fixation fracture as a possible reason for CCR, but computed tomographic angiography failed to confirm any endoleak or "active" bleeding and rupture. The patient received medication treatment for possible diverticulitis and was kept under close monitoring for suspected failure of recently performed secondary endovascular procedure and CCR. A day later, the abdominal pain symptoms worsened, and a new computed tomographic angiography confirmed the suspected CCR. The patient was treated successfully by "open" repair using a Y prosthesis. To our knowledge, this is the first reported case of post-EVAR CCR due to suprarenal fixation fatigue fracture. Lifelong post-EVAR follow-up with high level of both clinical and imaging diagnostic accuracy is essential for the early recognition and proper treatment of EVAR pitfalls.

DOI10.1016/j.avsg.2012.03.015
Alternate JournalAnn Vasc Surg
PubMed ID22944573

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