Late Rupture of an Abdominal Aortic Aneurysm after Parodi's Endoprosthesis Replacement

Swiss Surgery ◽  
2001 ◽  
Vol 7 (4) ◽  
pp. 190-193 ◽  
Author(s):  
De Monti ◽  
Ghilardi ◽  
Gobatti ◽  
Labagnara ◽  
Scorza
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Surgical Procedures ◽  
Aneurysm Rupture ◽  
Endovascular Surgery ◽  
Aortic Aneurysms ◽  
Retroperitoneal Haematoma ◽  
Abdominal Aortic ◽  
Prosthesis Replacement

Endovascular surgery as a whole, and specifically in the context of aortic aneurysms, is a very interesting methodology the potential of which is increasingly being recognized. Follow up information on patients who underwent these procedures will be critical to validate the different techniques which have been developed and to identify the most appropriate situations for this type of surgical procedures. The authors present a case of aortic aneurysm rupture who had undergone Parodi's endoprosthesis placement two years before. CT angiographic evaluation showed a wide endoleak due to distal stent detachment, a complete dislodging of the endoprosthesis itself and retroperitoneal haematoma. Prosthesis replacement through a laparotomic approach was carried out and the patient was discharged 10 days postoperatively, surgically cured.

scholarly journals Endovascular repair of aortic aneurysm: Preliminary results

2009 ◽  
Vol 137 (1-2) ◽  
pp. 10-17 ◽  
Author(s):  
Lazar Davidovic ◽  
Momcilo Colic ◽  
Igor Koncar ◽  
Dejan Markovic ◽  
Dusan Kostic ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Stent Graft ◽  
Endovascular Aneurysm Repair ◽  
Aortic Aneurysms ◽  
Endovascular Stent ◽  
Stent Grafts ◽  
Graft Thrombosis ◽  
Abdominal Aortic

Introduction. Endovascular aneurysm repair (EVAR) has been introduced into clinical practice at the beginning of the 90's of the last century. Because of economic, political and social problems during the last 25 years, the introduction of this procedure in Serbia was not possible. Objective. The aim of this study was to present preliminary experiences and results of the Clinic for Vascular Surgery of the Serbian Clinical Centre in Belgrade in endovascular treatment of thoracic and abdominal aortic aneurysms. Methods. The procedure was performed in 33 patients (3 female and 30 male), aged from 42 to 83 years. Ten patients had a descending thoracic aorta aneurysm (three atherosclerotic, four traumatic - three chronic and one acute as a part of polytrauma, one dissected, two penetrated atherosclerotic ulcers), while 23 patients had the abdominal aortic aneurysm, one ruptured and two isolated iliac artery aneurysms. The indications for EVAR were isthmic aneurismal localisation, aged over 80 years and associated comorbidity (cardiac, pulmonary and cerebrovasular diseases, previous thoracotomy or multiple laparotomies associated with abdominal infection, idiopatic thrombocitopaenia). All of these patients had three or more risk factors. The diagnosis was established using duplex ultrasonography, angiography and MSCT. In the case of thoracic aneurysm, a Medtronic-Valiant? endovascular stent graft was implanted, while for the abdominal aortic aneurysm Medtronic-Talent? endovascular stent grafts with delivery systems were used. In three patients, following EVAR a surgical repair of the femoral artery aneurysm was performed, and in another three patients femoro-femoral cross over bypass followed implantation of aortouniiliac stent graft. Results. During procedure and follow-up period (mean 1.6 years), there were: one death, one conversion, one endoleak type 1, six patients with endoleak type 2 that disappeared during the follow-up period, one early graft thrombosis. No other complications, including aneurysm expansion, collapse, deformity and migration of the endovascular stent grafts, were registered. Conclusion. According to all medical and economic aspects, we recommend EVAR to treat acute traumatic thoracic aortic aneurysm, as well as in elderly and high-risk patients with abdominal or thoracic aneurysms, when open surgery is related to a significantly higher mortality and morbidity.

The Nellix™ EndoVascular sealing system in patients with abdominal aortic aneurysms in conjunction with iliac artery occlusive disease

Vascular ◽  
2016 ◽  
Vol 25 (2) ◽  
pp. 190-195 ◽  
Author(s):  
Steven MM van Sterkenburg ◽  
Leo H van den Ham ◽  
Luuk Smeets ◽  
Jan-Willem Lardenoije ◽  
Michel MPJ Reijnen
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Iliac Artery ◽  
Occlusive Disease ◽  
Aortic Aneurysms ◽  
Covered Stents ◽  
Single Center ◽  
Technical Success ◽  
Abdominal Aortic

Introduction Concomitant abdominal aortic aneurysm formation and aortoiliac occlusive disease is a challenging combination, often requiring open reconstructive surgery. In this study, we have assessed a single center experience of the Nellix EndoVascular Aneurysm Sealing System in the treatment of an abdominal aortic aneurysm in conjunction with iliac artery occlusive disease. Methods Retrospectively case files of patients treated with Nellix EndoVascular Aneurysm Sealing System in a single center were reviewed. The primary endpoints of the study were the technical success of Nellix EndoVascular Aneurysm Sealing System in patients with coincidental iliac artery occlusive disease and the successful exclusion of the aneurysm during follow-up. Results Of the 96 patients that were treated with Nellix EndoVascular Aneurysm Sealing System, five were identified that had an abdominal aortic aneurysm in conjunction with iliac artery occlusive disease. Treated patients had either unilateral (n = 4) or bilateral (n = 1) common iliac artery occlusive disease varying from 70% stenosis to complete occlusions. The lesion length varied from 5 to 50 mm and in two cases it involved an occluded bare metal stent. The indication for surgery was the abdominal aortic aneurysm in all patients, including three also suffering from claudication. In all patients the iliac artery occlusive disease was pretreated with balloon-expandable covered stents. Technical success was achieved in all five patients. After a median follow-up of nine months all stents were patent with no signs of endoleak and stable aneurysm diameters. All patients were free of intermittent claudication or ischemic wounds. Conclusion Nellix EndoVascular Aneurysm Sealing System seems feasible and safe in patients with a combination of abdominal aortic aneurysm and iliac artery occlusive disease.

scholarly journals A case of successful surgical treatment of a ruptured giant aneurysm of the infrarenal aorta in an elderly patient

2021 ◽  
pp. 157-163
Author(s):  
A. E. Zotikov ◽  
M. R. Khokonov ◽  
K. Kh. Eminov ◽  
A. M. Solovieva ◽  
A. V. Kozhanova ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Abdominal Aortic Aneurysm ◽  
Surgical Treatment ◽  
Aortic Aneurysm ◽  
Giant Aneurysm ◽  
Aneurysm Rupture ◽  
Aortic Aneurysms ◽  
Infrarenal Aorta ◽  
Giant Aneurysms ◽  
Abdominal Aortic

Today, abdominal aortic aneurysm surgery is a fairly well-studied area of medicine. Nevertheless, some questions remain rather debatable. No clear criteria for giant aneurysms have been developed so far. The available foreign and domestic literature reports about 40 cases of surgical treatment of giant abdominal aortic aneurysms, 16 of which are cases of aneurysm rupture. Open surgery remains the method of choice in the treatment of giant aneurysms due to the pronounced technical difficulties of endovascular intervention. The authors present a case of successful surgical treatment of a giant aneurysm rupture in an elderly patient. The peculiarity of this patient's condition is the occurrence of aneurysm rupture after hospital admission. The patient refused surgical treatment for two years after aneurysm detection. On examination after admission, multispiral computed tomography revealed an aneurysm size of 101 mm. On the eve of surgery, pain syndrome in the left abdomen and tachycardia appeared. Aneurysm rupture was suspected and the patient was urgently admitted to the operating room. The surgery was performed under the conditions of machine reinfusion of autoblood. The patient underwent abdominal aortic aneurysm resection with linear prosthesis and retroperitoneal hematoma removal. The postoperative period had no peculiarities. On the 10th day after the operation the patient was discharged in satisfactory condition to the outpatient treatment. This clinical case demonstrates the possibility of successful surgical treatment of giant aneurysm rupture in elderly patients.

scholarly journals ASSESSMENT OF CLINICAL PRESENTATION OF ABDOMINAL AORTIC ANEURISM

2018 ◽  
Vol 5 (4) ◽  
pp. 161-164
Author(s):  
V. Boiko ◽  
O. Buchneva ◽  
Ya. Shafer ◽  
Yu. Pisklova ◽  
A. Krylova
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Clinical Manifestations ◽  
Aneurysm Rupture ◽  
Aortic Aneurysms ◽  
Vascular Involvement ◽  
Urgent Surgery ◽  
Abdominal Aortic ◽  
Abdominal Aortic Aneurism ◽  
Causes Of Mortality

Boyko V., Buchneva O. Shafer Ya., Pisklova Yu., Krylova O.To date, vascular disease rank first (more than 50%) among the causes of mortality in Ukraine. Atherosclerotic vascular involvement, being the most frequent etiological factor of abdominal aortic aneurysm, in the absence of timely diagnosis and treatment, causes severe complications, early disability and death. Clinical and functional diversity of abdominal aortic aneurysm causes difficulties in diagnosing, defining different therapeutic approaches, methods of operation and protection of visceral organs and spinal cord. The article analyzes various clinical manifestations of abdominal aortic aneurysms in 264 patients who underwent surgical treatment at the State Facility V.T Zaytsev Institute of General and Urgent Surgery from 2010 to 2018.Key words:a bdominal aortic aneurysm, rupture of abdominal aortic aneurysm РезюмеАНАЛІЗ КЛІНІЧНОГО ПЕРЕБІГУ АНЕВРИЗМ ЧЕРЕВНОГО ВІДДІЛУ АОРТИБойко В., Бучнєва О., Шафер Я., Пісклова Ю., Крилова О.На сьогоднішній деньзахворювання судин займають перше місце (більше 50%) серед причин смертності в Україні. Атеросклеротичнеураженнясудин, будучи найбільш частим етіологічним фактороманевризм черевного відділу аорти, за відсутності своєчасної діагностики і лікування викликає важкі ускладнення, ранню інвалідизацію і смерть. Клінічне і функціональне різноманіття аневризм черевної аорти викликає труднощі в діагностиці, визначає різну тактику лікування, способи операції тазахисту внутрішніх органів і спинного мозку. У статті проаналізовані різноманітні клінічні презентації аневризм черевного відділу аорти у 264 пацієнтів, яким було проведено хірургічне лікування на базі ДУ "ІЗНХ ім.В. Т.Зайцева" з 2010 по 2018 рік. Ключові слова: аневризма черевної аорти, розрив аневризми черевної аорти РезюмеАНАЛИЗ КЛИНИЧЕСКОГО ТЕЧЕНИЯ АНЕВРИЗМ БРЮШНОГО ОТДЕЛА АОРТЫБойко В., Бучнева О., Шафер Я., Писклова Ю., Крылова А.На сегодняшний день заболевания сосудов занимают первое место (более 50%) среди причин смертности в Украине. Атеросклеротическом поражении сосудов, являясь наиболее частым этиологическим фактором аневризм брюшного отдела аорты, при отсутствии своевременной диагностики и лечения вызывает тяжелые осложнения, раннюю инвалидизацию и смерть. Клиническое и функциональное многообразие аневризм брюшной аорты вызывает трудности в диагностике, определяет разную тактику лечения, способы операции и защиты внутренних органов и спинного мозга. В статье проанализированы разнообразные клинические презентации аневризм брюшного отдела аорты у 264 пациентов, которым было проведено хирургическое лечение на базе ДУ "ІЗНХ ім.В. Т.Зайцева" с 2010 по 2018 год.Ключевые слова: аневризма брюшной аорты, разрыв аневризмы брюшной аорты

3D Modeling of Blood Flow in Simulated Abdominal Aortic Aneurysm

2021 ◽  
pp. 153857442110129
Author(s):  
Mauricio Gonzalez-Urquijo ◽  
Raul Garza de Zamacona ◽  
Ana Karen Martinez Mendoza ◽  
Miranda Zamora Iribarren ◽  
Erika Garza Ibarra ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Shear Stress ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Abdominal Aortic Aneurysms ◽  
Aneurysm Rupture ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
Computer Aided

Background: Besides biological factors, abdominal aortic aneurysm rupture is also caused by mechanical parameters, which are constantly affecting the wall’s tissue due to their abnormal values. The ability to evaluate these parameters could vastly improve the clinical treatment of patients with abdominal aortic aneurysms. The objective of this study was to develop and demonstrate a methodology to analyze the fluid dynamics that cause the wall stress distribution in abdominal aortic aneurysms, using accurate 3D geometry and a realistic, nonlinear, elastic biomechanical model using a computer-aided software. Methods: The geometry of the abdominal aortic aneurysm; was constructed on a 3D scale using computer-aided software SolidWorks (Dassault Systems SolidWorksCorp., Waltham MA). Due to the complex nature of the abdominal aortic aneurysm geometry, the physiological forces and constraints acting on the abdominal aortic aneurysm wall were measured by using a simulation setup using boundary conditions and initial conditions for different studies such as finite element analysis or computational fluid dynamics. Results: The flow pattern showed an increase velocity at the angular neck, followed by a stagnated flow inside the aneurysm sack. Furthermore, the wall shear stress analysis showed to focalized points of higher stress, the top and bottom of the aneurysm sack, where the flow collides against the wall. An increase of the viscosity showed no significant velocity changed but results in a slight increase in overall pressure and wall shear stress. Conclusions: Conducting computational fluid dynamics modeling of the abdominal aortic aneurysm using computer-aided software SolidWorks (Dassault Systems SolidWorksCorp., Waltham MA) proves to be an insightful approach for the clinical setting. The careful consideration of the biomechanics of the abdominal aortic aneurysm may lead to an improved, case-specific prediction of the abdominal aortic aneurysm rupture potential, which could significantly improve the clinical management of these patients.

The Future of Abdominal Aortic Aneurysm Treatment and the Role of Totally Percutaneous Endografting

2010 ◽  
Vol 5 (1) ◽  
pp. 86
Author(s):  
Laura Capoccia ◽  
Vincent Riambau ◽  
◽  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Abdominal Aortic Aneurysm Repair ◽  
Aneurysm Rupture ◽  
Aortic Aneurysms ◽  
Mortality And Morbidity ◽  
Low Profile ◽  
Abdominal Aortic ◽  
Distal Migration ◽  
Randomised Controlled

Endovascular abdominal aortic aneurysm repair (EVAR) has experienced a continuous spread worldwide as a result of the constant drive to develop innovative methods and devices that enable physicians to achieve therapeutic aims while reducing procedural risks and patient discomfort. Randomised controlled studies have demonstrated clear early benefits over open repair in terms of mortality and morbidity, but a high reintervention rate jeopardised the EVAR outcome. Complications in EVAR, such as endoleaks, separation of modular components, stent or hook fractures and distal migration of the endograft, can lead to aneurysm enlargement and thus to the native risk of aneurysm rupture. In order to prevent such complications and minimise potential re-interventions, new-generation stent grafts, low-profile delivery systems and new percutaneous closing devices have been developed and adopted, making a totally percutaneous approach possible and desirable. Nevertheless, operators must be aware and trained to face every complication that could possibly develop during and after the procedure. Given these circumstances, EVAR is under consideration as the first line of treatment for abdominal aortic aneurysms.

Abdominal aortic endograft proximal collapse resulting in aortic aneurysm rupture

Vascular ◽  
2011 ◽  
Vol 19 (3) ◽  
pp. 159-162 ◽  
Author(s):  
Konstantinos G Moulakakis ◽  
Ilias Dalainas ◽  
Triantafillos G Giannakopoulos ◽  
Efthimios Avgerinos ◽  
Christos D Liapis
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Abdominal Aortic Aneurysm Repair ◽  
Aneurysm Rupture ◽  
Intravenous Contrast ◽  
Abdominal Aortic ◽  
Contrast Enhanced ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

An 82-year-old man was transferred to our emergency department due to acute abdominal pain. He had undergone an endovascular abdominal aortic aneurysm repair (EVAR) six years ago. An intravenous contrast-enhanced abdominal computed tomography revealed the rupture of the abdominal aortic aneurysm (AAA) with a large retroperitoneal hematoma. A Talent (Medtronic, Santa Rosa, CA, USA) modular bifurcated endoprosthesis had vertically collapsed approximately 7 cm after losing its infrarenal fixation. As a result, it led to the repressurization of the aneurysm sac and rupture. The patient was successfully treated by placing three Talent (Medtronic) aortic cuffs. To our knowledge, this is the first reported case of endograft collapse that has manifested with aortic aneurysm rupture. Although they are gradually declining, considerable rates of complications create the ‘Achilles’ heel' of endovascular repair of AAAs. A lifelong follow-up strategy for patients treated for AAA with EVAR is essential for the early detection and treatment of complications of the procedure.

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