Slides Endovascular
Endovascular Aneurysm Repair (EVAR) of Abdominal Aortic Aneurysm (AAA)
- Operator : Seung-Whan Lee
Endovascular Aneurysm Repair (EVAR) of Abdominal Aortic Aneurysm (AAA) |
- Operator: Seung-Whan Lee, MD |
Case Presentation |
A 69-year-old male was admitted to our hospital for the management of symptomatic infrarenal abdominal aortic aneurysm (AAA). 1 year ago, his AAA was initially detected on abdominal CT scan while he was evaluated for lumbar pain. He underwent lumbar pain 2 weeks ago. The increase in the aneurysmal diameter was found by follow-up using computed tomography (CT). On the last CT scan, maximal aneurysmal diameter increased from 4.7 cm to 5.0 cm for 1 year. |
Baseline Computed Tomography of the Abdominal Aorta |
CT showed an abdominal aortic aneurysm with mural thrombi, the extent of which was from 45mm distal to left renal artery to both common iliac arteries (Figure 1, Figure 2). |
Procedure |
Vascular accesses were obtained by insertion of two 7 Fr sheathes into both femoral arteries, and aortography was performed via right femoral artery using a 5 Fr pigtail diagnostic catheter ( Movie 1). We dilated the right femoral artery using 14 Fr and 18 Fr sheath dilator and then inserted and deployed the Endurant Stent Graft System 23-14-14mm/103 mm from AAA to right common iliac artery ( Movie 2, Figure 3). An Endurant Contralateral limb (16-10mm/93 mm) was deployed at left common iliac artery (Figure 4). We inserted two 14 Fr sheaths into both femoral arteries. Then, an Endurant Iliac Extension (16-13mm/93mm) was deployed at right common iliac artery ( Movie 3, Figure 5). The balloon dilatation was performed via left and right femoral artery with a Reliant balloon 46mm balloon at stent body and both bifurcated branches (Figure 6, Figure 7). Final angiogram showed successful exclusion of AAA without significant endoleak ( Movie 4). After the intervention, both puncture sites were closed by manual compression. |
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