Abstract
IntroductionEndovascular aortic repair, if technically feasible, is the treatment of choice for patients with a contained ruptured aortic aneurysm who are unfit for open surgery.Case presentationWe report the case of an 80-year-old Caucasian man who presented with an unusually configured, symptomatic infrarenal aortic aneurysm. His aneurysm showed an erosion of the fourth lumbar vertebra and a severely arteriosclerotic pelvic axis. A high thigh amputation of his right leg had been performed 15 months previously. On his right side, occlusion of his external iliac artery, common femoral artery, and deep femoral artery had occurred. His aneurysm was treated by a left-sided aortomonoiliac stent graft without femorofemoral revascularization, resulting in occlusions of both internal iliac arteries. No ischemic symptoms appeared, although perfusion of his right side was maintained only over epigastric collaterals.ConclusionsThe placement of aortomonoiliac stent grafts for endovascular treatment of infrarenal aortic aneurysms without contralateral revascularization is a feasible treatment option in isolated cases. In this report, access problems and revascularization options in endovascular aneurysm repair are discussed.
Highlights
Endovascular aortic repair, if technically feasible, is the treatment of choice for patients with a contained ruptured aortic aneurysm who are unfit for open surgery.Case presentation: We report the case of an 80-year-old Caucasian man who presented with an unusually configured, symptomatic infrarenal aortic aneurysm
The placement of aortomonoiliac stent grafts for endovascular treatment of infrarenal aortic aneurysms without contralateral revascularization is a feasible treatment option in isolated cases
The applicability of aortic stent grafts is limited by accessibility of the pelvic axis
Summary
Endovascular exclusion of an infrarenal aortic aneurysm may be performed using aortobiiliac or aortomonoiliac stent grafts. The applicability of aortic stent grafts is limited by accessibility of the pelvic axis. Both perfusion of the two internal iliac arteries and - if aortomonoiliac stent grafts are placed - perfusion of the contralateral leg have to be considered. This case report describes a patient with an unusually configured infrarenal aortic aneurysm with a difficult vascular anatomy. Highlights that the endovascular treatment of an infrarenal aortic aneurysm has to be adjusted to the clinical requirements and vascular anatomy of each patient
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