Endovascular stent-graft placement for nonaneurysmal infrarenal aortic rupture: a case report and review of the literature

Vasquez, Jay; Poultsides, George A.; Lorenzo, Aldenb; Foster, John E.; Drezner, A. David; Gallagher, James J.

doi:10.1016/s0741-5214(03)00557-3

Cited by 23 publications

(13 citation statements)

References 13 publications

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“…Therefore, compared with fusiform aneurysms, the risks of migration and endoleak as complications specific to stent grafting decrease. 2,8,11,16,17,21,24) In the future, stent grafting as well as surgery will be a treatment choice based on the patient's general condition and preoperative activity.…”

Section: Resultsmentioning

confidence: 99%

Abdominal Aortic Disease Caused by Penetrating Atherosclerotic Ulcers

Satô

Imai

Sakamoto

et al. 2012

Annals of Vascular Diseases

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Objective: Penetrating atherosclerotic ulcer (PAU) of the aorta is defined as an atherosclerotic lesion with ulceration of the aortic intima and media and rupture of the internal elastic lamina. PAU induced aortic dissection, aortic rupture, and secular aortic aneurysm and typically occurs in elderly hypertensive patients with severe atherosclerosis. Although it has been reported that atherosclerosis similarly occurs in the abdominal aorta, its natural history and treatment are still unclear. This study investigated the clinical features, natural history, and treatment of PAU of the abdominal aorta.

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Section: Resultsmentioning

confidence: 99%

Abdominal Aortic Disease Caused by Penetrating Atherosclerotic Ulcers

Satô

Imai

Sakamoto

et al. 2012

Annals of Vascular Diseases

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“…His pseudoaneurysm occurred secondary to a ruptured ulcerated atherosclerotic plaque. There had been reported cases of pseudoaneurysm resulting from spontaneous atherosclerotic plaque rupture, but most of them have been from the thoracic aorta instead of the abdominal aorta [11]. It is important to note that a pseudoaneurysm can become infected and a non-pulsatile infected pseudoaneurysm may present similarly to an abscess [1].…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Infrarenal Abdominal Aortic Pseudoaneurysm: A Case Report

Jian

2014

J Curr Surg

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A pseudoaneurysm is an abnormal focal dilation of a blood vessel contained within a fibrous capsule that is not composed of all three layers of the vessel (intima, media and adventitia). The wall of a pseudoaneurysm is therefore made up of the normal structures surrounding the artery and any thrombus lining the cavity. Factors predisposing the formation of pseudoaneurysms include trauma to the vessel wall, disrupted surgical anastomosis, unidentified injuries to vessel walls during catheterizations and endovascular procedures, and complications related to anticoagulation and antiplatelet therapy in patients undergoing invasive arterial interventions. We present here an unusual case of a 55-year-old Caucasian male with an abdominal aortic pseudoaneurysm formed secondary to a ruptured ulcerated atherosclerotic plaque inferior to the renal vessels. He presented with a month's history of worsening back and testicular pain cumulating to a visit to the Emergency Department. He underwent urgent surgical repair of the pseudoaneurysm followed by an uneventful recovery. This report discusses the etiology, presentation, management and the possible complications of an abdominal aortic pseudoaneurysm.

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“…In patients with the associated risk factors who are in the appropriate age range and have a history of symptoms such as persistent abdominal pain, back pain or flank pain, the diagnosis of PAU at the infrarenal aorta must be entertained [4]. Abdominal CT imaging of the aorta should be performed for symptomatic patients, but the absence of an aortic aneurysm or dissection should not completely eliminate the aorta as the source of symptoms [5].…”

Section: Discussionmentioning

confidence: 99%

“…Abdominal CT imaging of the aorta should be performed for symptomatic patients, but the absence of an aortic aneurysm or dissection should not completely eliminate the aorta as the source of symptoms [5]. The natural prognosis of PAU remains unclear, and the treatment of PAU remains controversial [4]. Possible progressive complications of PAU extending beyond the aortic wall are subadventitial pseudoaneuryms and transmural rupture with an extra-aortic hematoma [1].…”

Section: Discussionmentioning

confidence: 99%

Endovascular aortic repair for spontaneous rupture of a non-aneurysmal infrarenal aorta

Kainuma¹,

Kuratani²,

Kin³

et al. 2011

Interactive CardioVascular and Thoracic Surgery

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We report the case of a patient who underwent an endovascular aortic repair for spontaneous rupture of a non-aneurysmal infrarenal aorta. A 67-year-old male with a diagnosis of infrarenal aortic rupture was referred to our hospital. Preoperative computed tomography showed focal ulcers adjacent to the site of rupture, with no evidence of aneurysm formation, suggesting that this aortic rupture was likely to be associated with perforation of penetrating atheromatous ulceration. Open surgical repair might have carried a high-risk because of the patient's history of laparotomy and respiratory impairment, so endovascular aortic repair was planned. We deployed a Powerlink proximal infrarenal cuff 25-25-75L at the rupture site through the femoral artery, with the additional placement of two extra large Palmaz stents at the proximal and distal sites of the Powerlink stent-graft. Completion angiography showed total exclusion with no endoleaks. The patient was successfully extubated on the third postoperative day and recovered well until he contracted aspiration pneumonia two weeks after surgery. Unfortunately, he eventually died of a non-aortic cause three months after the operation. Endovascular aortic repair may be an alternative to conventional surgical repair for high-risk patients with spontaneous infrarenal aortic rupture.

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Endovascular stent-graft placement for nonaneurysmal infrarenal aortic rupture: a case report and review of the literature

Cited by 23 publications

References 13 publications

Abdominal Aortic Disease Caused by Penetrating Atherosclerotic Ulcers

Abdominal Aortic Disease Caused by Penetrating Atherosclerotic Ulcers

Symptomatic Infrarenal Abdominal Aortic Pseudoaneurysm: A Case Report

Endovascular aortic repair for spontaneous rupture of a non-aneurysmal infrarenal aorta

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