Hemodynamic Conditions may Influence the Oversizing of Stent Grafts and the Postoperative Surveillance of Patients with Ruptured Abdominal Aortic Aneurysm Treated by EVAR.
Details
Serval ID
serval:BIB_0D7A3F0EC190
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Hemodynamic Conditions may Influence the Oversizing of Stent Grafts and the Postoperative Surveillance of Patients with Ruptured Abdominal Aortic Aneurysm Treated by EVAR.
Journal
Annals of vascular surgery
ISSN
1615-5947 (Electronic)
ISSN-L
0890-5096
Publication state
Published
Issued date
01/2016
Peer-reviewed
Oui
Volume
30
Pages
308.e5-10
Language
english
Notes
Publication types: Journal Article Publication Status: ppublish
Publication types: Case Reports ; Journal Article
Publication types: Case Reports ; Journal Article
Abstract
To report the causes of second rupture in patients treated with a stent graft for ruptured abdominal aortic aneurysm (rAAA).
A 69-year-old man was admitted for abdominal pain and hypovolemic shock 22 months after endovascular exclusion of an rAAA with an aortomonoiliac stent graft and a crossover bypass despite normal duplex ultrasound and sac shrinkage at 1 year. During emergent laparotomy, a type IA endoleak was discovered and the aortomonoiliac stent graft was explanted. A Dacron bypass was interposed between the infrarenal aorta and the iliac extension stent graft.
Considering the literature, this report has 3 implications for the endovascular treatment of rAAA. First, 30% oversizing is preferable to 15% when treating an rAAA assessed by computed tomography angiography (CTA) performed during permissive hypotension. Second, the surveillance program should rely on CTA and not on a duplex examination to detect any endoleaks or migration. Finally, partial stent graft explantation is a valid option for decreasing aortic clamping time.
A 69-year-old man was admitted for abdominal pain and hypovolemic shock 22 months after endovascular exclusion of an rAAA with an aortomonoiliac stent graft and a crossover bypass despite normal duplex ultrasound and sac shrinkage at 1 year. During emergent laparotomy, a type IA endoleak was discovered and the aortomonoiliac stent graft was explanted. A Dacron bypass was interposed between the infrarenal aorta and the iliac extension stent graft.
Considering the literature, this report has 3 implications for the endovascular treatment of rAAA. First, 30% oversizing is preferable to 15% when treating an rAAA assessed by computed tomography angiography (CTA) performed during permissive hypotension. Second, the surveillance program should rely on CTA and not on a duplex examination to detect any endoleaks or migration. Finally, partial stent graft explantation is a valid option for decreasing aortic clamping time.
Keywords
Aged, Aortic Aneurysm, Abdominal/complications, Aortic Aneurysm, Abdominal/diagnosis, Aortic Aneurysm, Abdominal/surgery, Aortic Rupture/diagnosis, Aortic Rupture/etiology, Aortic Rupture/surgery, Blood Vessel Prosthesis/adverse effects, Blood Vessel Prosthesis Implantation/adverse effects, Endoleak/diagnosis, Endoleak/etiology, Endoleak/surgery, Endovascular Procedures/adverse effects, Humans, Hypotension/complications, Male, Prosthesis Fitting/adverse effects, Stents/adverse effects
Pubmed
Create date
11/10/2016 15:30
Last modification date
20/08/2019 12:34
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