Small ruptured abdominal aortic aneurysm with renal failure: endovascular treatment--a case report
Vascular and Endovascular Surgery
Germano MelissanoRoberto Chiesa
The successful endovascular exclusion of a ruptured 3-cm diameter atherosclerotic abdominal aortic aneurysm (AAA) in a high-risk patient with renal failure is reported. An 82-year-old man with chronic renal failure and other comorbidities was admitted for acute abdominal pain. Duplex scan and computed tomography showed a ruptured 3-cm diameter atherosclerotic AAA. As a consequence of the patient's high surgical risk combined with signs of rupture, despite the progressively decreasing renal function, an emergency exclusion of the AAA was performed by means of a bifurcated Excluder (W. L. Gore and Associates) endovascular graft. The procedure was performed by minimizing administration of iodinated contrast medium using a guidewire into the lowest renal artery as a marker of proximal deployment. Intravascular ultrasound was used to confirm correct deployment. The postoperative recovery was characterized by acute renal insufficiency and bowel ischemia, which were treated with ultrafiltration and medical therapy, respectively, with complete resolution.
An aortic aneurysm is the weakening and bulging of the blood vessel wall in the aorta. This causes dilatation of the aorta, which is usually asymptomatic but carries the risk of rupture and hemorrhage. Find the latest research on aortic aneurysms here.