Successful Endovascular Aortic Repair (EVAR) for an Abdominal Aortic Aneurysm with a Shaggy Aorta Using a Temporary Filtered Aorto-Venous Shunt for Protection against Shower Embolism

Abstract

Endovascular aortic repair (EVAR) is generally considered to be contraindicated in the presence of a shaggy aorta, because of the high risk of shower embolization. However, many patients who have abdominal aortic aneurysms (AAAs) with diffuse aortic atherosclerosis need EVAR because of high surgical risk. We report a case of AAA with massive aortic plaques that was treated with EVAR, using an extracorporeal shunt with a blood filter constructed from the femoral artery and vein during the procedure. The patient had an uneventful postoperative course. This method of sieving emboli in a filter in an external shunt is highly effective for EVAR of a shaggy aorta.