Acute Testicular Ischemia following Endovascular Abdominal Aortic Aneurysm Repair Identified in the Emergency Department.

Nathan Finnerty,Andrew King,Stephen Rancour

doi:10.1155/2014/591820

Nathan Finnerty, Andrew King + Show 1 more

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https://doi.org/10.1155/2014/591820

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Abstract

Endovascular aneurysm repair (EVAR) is perhaps the most widely utilized surgical procedure for patients with large abdominal aortic aneurysms. This procedure is minimally invasive and reduces inpatient hospitalization requirements. The case involves a 72-year-old male who presented to the emergency department with right testicular ischemia two days following EVAR. Given the minimal inpatient hospitalization associated with this procedure, emergency physicians are likely to encounter associated complications. Ischemic and thromboembolic events following EVAR are extremely rare but require prompt vascular surgery intervention to minimize morbidity and mortality.

Highlights

Endovascular aneurysm repair (EVAR) is becoming the firstline treatment option for many patients with large abdominal aortic aneurysms (AAA) [1]
Ischemic and thromboembolic events following EVAR are extremely rare but may present an emergent threat to life and limb [2, 3]. Recognition of such complications in the emergency department is crucial as these events are more likely to present out of hospital given the reduced hospitalization requirements following EVAR and the potential need for emergent vascular surgical intervention to reduce morbidity and mortality related to these events [1,2,3]
An abdominal aortic aneurysm (AAA) is an abnormal dilation of the major abdominal artery found in 5% to 10% of men aged 65 to 79 years [4, 5]

Summary

Introduction

Endovascular aneurysm repair (EVAR) is becoming the firstline treatment option for many patients with large abdominal aortic aneurysms (AAA) [1]. Ischemic and thromboembolic events following EVAR are extremely rare but may present an emergent threat to life and limb [2, 3]. Recognition of such complications in the emergency department is crucial as these events are more likely to present out of hospital given the reduced hospitalization requirements following EVAR and the potential need for emergent vascular surgical intervention to reduce morbidity and mortality related to these events [1,2,3]. This paper reviews the epidemiology, clinical presentation, and management of acute testicular ischemia following EVAR. After thorough review of the literature, this is only the second such report in the United States and the third internationally

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