Treatment Using Endovascular Aneurysm Repair(EVAR) of Triple A

- Operator : John R. Laird

Treatment Using Endovascular Aneurysm Repair(EVAR) of Triple A

- Operator: John R. Laird, MD

Case Presentation

A 61 year old man was admitted for increased size of abdominal aortic aneurysm (40mm  50mm for 2 years). He had a long standing history of hypertension.

Baseline Computed Tomography of the Abdominal Aorta

Computed tomography of the abdominal aorta revealed increased size of the infrarenal abdominal aortic aneurysm (50 mm x 47 mm).

Procedure

Both femoral arteries were punctured with 8 Fr sheath. After insertion of the graduated sizing pigtail catheter (5 Fr) into the Rt femoral arteries, we performed aortography ( Movie 1). We dilated the right femoral artery using 18 Fr sheath dilator and then inserted and deployed the Endurant Stent Graft System 18 Fr (25-13-14mm/145mm bifurcated stent graft system) ( Movie 2). Endurant Stent Graft System Limb 14Fr (16-16mm/93mm stent graft system) was inserted and deployed at the left common iliac artery ( Movie 3). And then High pressure balloon dilatation was done with Reliant balloon 46mm at the bifurcated body repeatedly ( Movie 4). However, aortography showed significant endoleak ( Movie 5). Therefore, palmaz peripheral stent 14-25mm(37.79-30.58mm) was deployed at the endoleak site ( Movie 6). Final angiogram showed successful exclusion of the abdominal aortic aneurysm without endoleks ( Movie 7).