Case

Percutaneous EndoVascular Abdominal Aortic Aneurysm Repair Using Gore's EXCLUDER AAA Endoprosthesis

- Operator : John R. Laird

Percutaneous EndoVascular Abdominal Aortic Aneurysm Repair Using Gore's EXCLUDER AAA Endoprosthesis
- Operator: John R. Laird, MD
Clinical Information

- Relevant clinical history and physical exam:
A 61-year old man was admitted to increasing size of abdominal aortic aneurysm. He received CABG & thoracic aortic aneurysm with hybrid technique 3 months ago.
- Relevant test results prior to catheterization:
A CT scan showed 50 mm sized fusiform shaped AAA with thrombus. (Figure 1)

Interventional Management

- Procedural step:
Both femoral arteries were punctured with 6 Fr sheath. Using 2 Perclose Proglide 6 Fr at both side respectively, we changed 8 Fr sheath. With pigtail catheter, aortography was done. After 0.035 inch Terumo wire insertion, Lt. femoral sheath was changed into FLEXOR BALKIN CONTRALATERAL 6 Fr sheath and then Vascular Plug II Amplatzer 12 mm was inserted into Rt. Internal iliac artery. (Figure 2) Both femoral sheath were changed into 12 Fr at Lt. side & 18 Fr at Rt. side. An EXCLUDER Trunk-ipsilateral leg 26X12X160 mm stent was deployed. (Figure 3) After stent insertion, Coda balloon (10 Fr, 32 mm sized) was inflated into in-stent area. EXCLUDER iliac extender 16X10X70 mm stent was deployed at Rt. external iliac artery. (Figure 4) And then, 0.035 inch Terumo wire was advanced into excluder body area. EXCLUDER contralateral leg 14.5X120 mm stent was implanted into Lt. CIA. (Figure 5) High pressure balloon dilatation was done with Coda balloon (10 Fr, 32 mm sized). Final angiogram showed successful exclusion of AAA. (Figure 6) Using Perclose device, Both femoral site hemostaisis were successfully achieved.

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