Endovascular Treatment of a Chronically Thrombosed Abdominal Aortic Aneurysm: Technical Considerations.


Journal

Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941

Informations de publication

Date de publication:
Apr 2020
Historique:
received: 17 08 2019
accepted: 18 09 2019
pubmed: 22 10 2019
medline: 25 8 2020
entrez: 22 10 2019
Statut: ppublish

Résumé

Chronic thrombosis of an abdominal aortic aneurysm (AAA) is a rare entity and the ideal management is debatable. A 74-year-old man presented with an enlarging chronically thrombosed AAA and incapacitating bilateral claudication, worse on the left side. We opted for an endovascular approach. Under local anesthesia and via a left axillary and left femoral cutdown, an aorto-uni-iliac stent graft (Endurant, Medtronic) was implanted down the left common iliac artery. A femorofemoral crossover bypass was not necessary because the right leg circulation was considered adequate on completion of the endovascular procedure. He had an uneventful recovery. His left leg symptoms were completely resolved and he was able to walk with only moderate right leg claudication after 300-400m. Endovascular treatment of a chronically thrombosed AAA can be performed under local anesthesia and is a safe alternative to open surgery in high-risk patients. The long-term results need further investigation.

Sections du résumé

BACKGROUND BACKGROUND
Chronic thrombosis of an abdominal aortic aneurysm (AAA) is a rare entity and the ideal management is debatable.
METHODS AND RESULTS RESULTS
A 74-year-old man presented with an enlarging chronically thrombosed AAA and incapacitating bilateral claudication, worse on the left side. We opted for an endovascular approach. Under local anesthesia and via a left axillary and left femoral cutdown, an aorto-uni-iliac stent graft (Endurant, Medtronic) was implanted down the left common iliac artery. A femorofemoral crossover bypass was not necessary because the right leg circulation was considered adequate on completion of the endovascular procedure. He had an uneventful recovery. His left leg symptoms were completely resolved and he was able to walk with only moderate right leg claudication after 300-400m.
CONCLUSIONS CONCLUSIONS
Endovascular treatment of a chronically thrombosed AAA can be performed under local anesthesia and is a safe alternative to open surgery in high-risk patients. The long-term results need further investigation.

Identifiants

pubmed: 31634595
pii: S0890-5096(19)30870-2
doi: 10.1016/j.avsg.2019.09.028
pii:
doi:

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

409.e1-409.e5

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Christos D Karkos (CD)

5th Department of Surgery, Medical School, Aristotle University of Thessaloniki, Hippocratio Hospital, Thessaloniki, Greece. Electronic address: ckarkos@hotmail.com.

Nikolaos Asaloumidis (N)

5th Department of Surgery, Medical School, Aristotle University of Thessaloniki, Hippocratio Hospital, Thessaloniki, Greece.

Maria Mitka (M)

5th Department of Surgery, Medical School, Aristotle University of Thessaloniki, Hippocratio Hospital, Thessaloniki, Greece.

Ioakeim T Giagtzidis (IT)

5th Department of Surgery, Medical School, Aristotle University of Thessaloniki, Hippocratio Hospital, Thessaloniki, Greece.

Konstantinos O Papazoglou (KO)

5th Department of Surgery, Medical School, Aristotle University of Thessaloniki, Hippocratio Hospital, Thessaloniki, Greece.

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