Iliac Extension Trimming, Resheathing, and Deployment for Emergent Repair of Abdominal Aortic Pseudoaneurysm

Abstract

An 18-year-old woman presented with a 3-week history of severe abdominal pain radiating to the back and left thigh, without trauma or fever. Clinical examination revealed pulsatile swelling in the umbilical region. Computed tomography angiography showed a large pseudoaneurysm (measuring 8.4 × 4.1 × 6.8 cm) arising from the left lateral aspect of the infrarenal abdominal aorta, with a narrow neck (8 mm) (Fig 1a–c). Circumferential mural thickening involving the descending thoracic aorta causing diffuse luminal narrowing was noted (Fig 1c), with multiple enlarged cervical and mediastinal necrotic lymph nodes.