Occluding aortic endoluminal stent graft combined with extra-anatomic axillofemoral bypass as alternative management of abdominal aortic aneurysms for patients at high risk with complex anatomic features: A preliminary report

Abstract

Placement of an occluding endograft associated with axillofemoral bypass grafting is a good alternative for patients at high risk with complex anatomic features. Longer-term follow-up study is needed to evaluate this endoluminal technique.

Extra-anatomic arterial reconstruction with ligation of common iliac arteries and embolization of the aneurysm for the treatment of abdominal aortic aneurysms in high-risk patients

“…Similar rates of survival are seen in patients with similar medical conditions; however, long-term studies are not yet available. 15 However, the technical constraints of this new technology limit its usefulness. Our nonresective treatment can be applied to any patient unsuitable for traditional repair, whereas the endoluminal stenting is only useful in patients with specific aneurysm morphology.…”

Incidental Discovery of a Chronically Thrombosed Abdominal Aortic Aneurysm: Case Report and Literature Review

“…Although our patient's thrombosed AAA remained stable on follow-up imaging, patients with chronically thrombosed AAAs are at significant risk for complications secondary to proximal propagation of the thrombus leading to occlusion of the renal and mesenteric arteries. 5,15 Corson et al 4 reported that in 14 of 27 chronically occluded AAAs, the thrombus involved the renal arteries, suggesting that the natural history of AAAs may involve proximal extension. Additionally, Starrett et al 16 reported a 46% mortality for patients with infrarenal aortic occlusion that extended to the renal or mesenteric arteries who were managed nonoperatively.…”

A unique technique for intentional occlusion of an abdominal aortic aneurysm

“…6 In this series, occlusion was achieved in 12 of 15 patients, with the three failures requiring intravascular occlusion using bucrylate. Numerous case series have been published, [5][6][7][8][9][10][11][12][13][14] ranging from 4 to 60 patients, on outcomes of extra-anatomic bypass, followed by aortic occlusion. All patients had contraindications to open aortic aneurysmorrhaphy.…”

“…One series that involved endovascular occlusion using a stent graft was published in 1998 by Le Minh et al, 11 who reported an 11% mortality rate at their follow-up of 1 year. The authors modified an endograft before deployment by physically cutting the graft to achieve the desired length, followed by placement of a nonabsorbable suture to make it occlusive.…”