Endovascular Repair of a Large Abdominal Aortic Aneurysm in a Patient Presenting with Lower Extremity Edema as a Result of Inferior Vena Cava Thrombosis

Endovascular Repair of an Abdominal Aortic Aneurysm with Iliac Vein Compression Syndrome

“…There have only been two reports of EVAR for iliac vein compression syndrome. 9,10) In these reports, it was reported that after EVAR, the mass effect on the surrounding structures persisted although the pulsatile force reduced soon after the procedure. Therefore, the relief of venous compression was slower than that of an open surgery.…”

“…A CT scan 3 months after the endovascular treatment for one patient showed no remarkable changes in aneurysm size and venous compression persisted, but the lower limb edema resolved clinically. 10) Aneurysmal aorta and iliac artery repair with an endograft results in transfer of aortic pulsatile flow and associated shear forces from the aneurysm walls to the lumen of an endograft, thereby reducing aneurysm vessel wall stress and ultimately size. 9) Combe et al 7) reported two patients who underwent an exclusion of the aneurysm in combination with an axial bi-femoral bypass.…”

Symptomatic abdominal aortic aneurysm (AAA) presenting as unilateral lower limb swelling: A case report

“…Previously, the acute management in such scenarios would have been open repair to ensure exclusion of the aneurysm as well as relief of extrinsic caval compression [ 3 , 7 , 8 ]. However, the utilisation of EVAR (endovascular aortic aneurysm repair) is now being proposed with Li et al (2017) identifiying the successful utilisation of EVAR in the treatment of a symptomatic AAA causing caval compression [ 9 ].…”

“…Post-operative change in aneurysm diameter has varied in the literature but in those without shrinkage, resolution of symptoms is thought to be secondary to aneurysmal sac depressurisation via endovascular stent graft placement [ 10 ]. As highlighted by Lin et al [ 9 ], the reduction in compression of the IVC due to noted depressurisation of the aneurysmal sac probably induced the restoration or recanalisation of the thrombosed IVC resulting in an increase in venous flow with subsequent symptom resolution. We also prescribed ongoing formal anticoagulation with bilateral thigh high compression stockings to alleviate the symptoms of post-thrombotic syndrome (PTS).…”