Endovascular Repair of a Blunt Abdominal Aortic Injury

Background: Injury to the abdominal aorta as part of a blunt injury is a rare event and is normally associated with other abdominal injuries. The management of these injuries can be non-operative, open repair or endovascular repair. Methods: We present two cases of blunt abdominal aortic injury in which the aorta was the only abdominal injury. This is followed by a review of the current literature. Results: Both these cases were treated endovascularly with good results. Conclusions: BAAIs are rare, and can occur in isolation, i.e. without any accompanying abdominal injuries. Despite historically being treated mostly by open repair, endovascular repair offers many advantages and can be safely managed.

Download Full-text

Ten-Year Follow-Up after Endovascular Repair of Traumatic Abdominal Aortic Rupture

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0b013e3182087993 ◽

2011 ◽

Vol 6 (1) ◽

pp. 51-53

Author(s):

Stephen Nicholls ◽

Riyad Karmy-Jones

Keyword(s):

Endovascular Repair ◽

Aortic Rupture ◽

Graft Infection ◽

Aortic Injury ◽

Bowel Injury ◽

Operative Repair ◽

Abdominal Aortic ◽

Aortic Injuries ◽

And Migration

Blunt abdominal aortic injury is often associated with bowel injury that precludes operative repair because of the risk of graft infection. Endovascular repair has been reported but with limited follow-up. We present a case of a 15-year-old boy who underwent endovascular repair of blunt abdominal aortic rupture and whom we were able to follow up over a decade. Our experience with this case and three others, as well as the experience reported in the literature, suggests that endovascular repair is a reasonable option in the setting of concomitant bowel injury. The risk of over sizing, collapse, and migration may be less than that described for thoracic aortic injuries because there is no need to deploy the endograft across an angle.

Download Full-text

Successful Endovascular Repair of a Leaking Abdominal Aortic Aneurysm under Local Anesthesia

Swiss Surgery ◽

10.1024/1023-9332.7.2.86 ◽

2001 ◽

Vol 7 (2) ◽

pp. 86-89 ◽

Cited By ~ 17

Author(s):

Lachat ◽

Pfammatter ◽

Bernard ◽

Jaggy ◽

Vogt ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Ct Scan ◽

Local Anesthesia ◽

Endovascular Repair ◽

Anesthetic Management ◽

High Risk Patient ◽

Invasive Technique ◽

Chronic Obstructive ◽

Abdominal Aortic

Local anesthesia is a safe and less invasive anesthetic management for the endovascular approach to elective aortic aneurysm. We have successfully extended the indication of local anesthesia to a high-risk patient with leaking aneurysm and stable hemodynamics. Patient and methods: A 86 year old patient with renal insufficiency due to longstanding hypertension, coronary artery and chronic obstructive lung disease was transferred to our hospital with a leaking abdominal aortic aneurysm. Stable hemodynamics allowed to perform a fast CT scan, that confirmed the feasibility of endovascular repair. A bifurcated endograft (24mm x 12mm x 153mm) was implanted under local anesthesia. Results: The procedure was completed within 85 minutes without problems. The complete sealing of the aneurysm was confirmed by CT scan on the third postoperative day. Twenty months later, the patient is doing well and radiological control confirmed complete exclusion of the aneurysm. Discussion: The endoluminal treatment is a minimally invasive technique. It's feasibility can be rapidly assessed by CT scan. The transfemoral implantation can be performed under local anesthesia provided that hemodynamics are stable. This anesthetic management seems to be particularly advantageous for leaking abdominal aortic aneurysm since it doesn't change the hemodynamic situation in contrast to general anesthesia. Hemodynamic instability, abdominal distension or tenderness may indicate intraperitoneal rupture and conversion to open graft repair should be performed without delay.

Download Full-text

Symptomatic Sac Enlargement and Rupture Due to Seroma After Open Abdominal Aortic Aneurysm Repair With Polytetrafluoroethylene Graft: Implications for Endovascular Repair and Endotension

Yearbook of Vascular Surgery ◽

10.1016/s0749-4041(08)70141-6 ◽

2006 ◽

Vol 2006 ◽

pp. 169-170

Author(s):

W.A. Lee

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Endovascular Repair ◽

Abdominal Aortic Aneurysm Repair ◽

Abdominal Aortic ◽

Aneurysm Repair ◽

Aortic Aneurysm Repair

Download Full-text

Stents for the Treatment of Aortic Aneurysms

Thrombosis and Haemostasis ◽

10.1055/s-0037-1615578 ◽

1999 ◽

Vol 82 (S 01) ◽

pp. 171-175 ◽

Cited By ~ 1

Author(s):

D. Ebert ◽

M. Langer ◽

P. Uhrmeister

Keyword(s):

Endovascular Treatment ◽

Endovascular Repair ◽

Abdominal Aortic Aneurysms ◽

Aortic Aneurysms ◽

Imaging Modalities ◽

Exclusion Criteria ◽

Multicenter Studies ◽

Abdominal Aortic ◽

First Results

SummaryThe endovascular treatment of abdominal aortic aneurysms has generated a great deal of interest since the early 1990s, and many different devices are currently available. The procedure of endovascular repair has been evaluated in many institutions and the different devices are compared. The first results were encouraging, but complications like endoleak, dislocation or thrombosis of the graft occurred. By the available devices the stent application is only promising, if the known exclusion criteria are strictly respected. Therefore a careful preinterventional assessment of the patient by different imaging modalities is necessary. As the available results up to now are preliminary and the durability of the devices has to be controlled, multicenter studies are required to improve the devices and observe their long- term success in the exclusion of abdominal aortic aneurysms.

Download Full-text