Cattell-Braasch Maneuver: A Gadget to Manipulate Abdominal Aortic Aneurysm in a Patient with a Left-Sided Inferior Vena Cava

Abstract

A 76-year-old man was diagnosed with abdominal aortic aneurysm and a left-sided inferior vena cava. He underwent open surgery, and we employed the Cattell-Braasch maneuver to approach the abdominal aortic aneurysm from the right side. This enabled securing of the abdominal aortic aneurysm neck without mobilizing or dissecting the inferior vena cava. His postoperative course was uneventful. Although abdominal aortic aneurysm is typically approached from the left side in open surgery, approaching from the right side is beneficial in patients with abdominal aortic aneurysm and a left-sided inferior vena cava.

Evacuation Technique of Left-Sided Inferior Vena Cava for a Successful Open Repair of a Large Juxtarenal Aortic Aneurysm

“…An alternative would be a left retroperitoneal approach [ 9 ] with known limitations in managing right iliac artery pathologies such as aneurysms and occlusive diseases. Other technical options include the use of a right retroperitoneal approach [ 10 ] or right medial visceral rotation with the Cattell-Braasch maneuver [ 11 ].…”

Vascular and Urinary Tract Anatomic Variants Relevant to Para-Aortic Lymphadenectomy in Women with Gynecological Cancers

“…Special attention is needed to avoid torsion of the colon and the small bowel mesentery, as this may cause ischemia [12]. The Cattell-Braasch maneuver carries the risk of injury to the duodenum, pancreas and ascending colon, and right ureter, and could causes paralytic ileus [13]. A disadvantage of laparotomy with the Cattell-Braasch maneuver may be delayed recovery of gastrointestinal function [14], which may result in a poorer prognosis for patient discharge from the hospital.…”