Slides Endovascular Abdominal Aorta
Endovascular Aneurysm Repair (EVAR) of Abdominal Aortic Aneurysm
- Operator : Seung-Whan Lee
Endovascular Aneurysm Repair (EVAR) of Abdominal Aortic Aneurysm (AAA) |
- Operator: Seung-Whan Lee, MD |
Case Presentation |
An 55-year-old male was referred to our hospital for the management of progressively enlarging infrarenal abdominal aortic aneurysm (AAA). His AAA was initially detected after general health check-up about 2 years ago and the increase in the aneurysmal diameter was found by regular follow-up using computed tomography (CT). On the last CT scan, maximal aneurysmal diameter had been increased from 4.9 cm to 5.6 cm for 1 year. He was ex-smoker and had history of ischemic heart disease. |
Baseline Computed Tomography of the Abdominal Aorta |
CT showed an abdominal aortic aneurysm with mural thrombi, the extent of which was from 28.7mm distal to right renal artery to aortic bifurcation (Figure 1, Figure 2). |
Procedure |
Both femoral arteries were punctured with 8 Fr sheath, both of which were replaced with two 8 Fr Proglide devices and aortography was done via right femoral artery using a 5 Fr pigtail diagnostic catheter ( Movie 1). We dilated the left femoral artery using 14 Fr sheath dilator and then inserted and deployed the Endurant Stent Graft System 20 Fr (28-16-14mm/170mm bifurcated stent graft system) ( Movie 2, Figure 3). An Endurant stent graft system limb 14Fr (16-13mm/120mm) was deployed at right common iliac artery ( Movie 3). The balloon dilatation was done via left and right femoral artery with a Reliant 46mm balloon at stent body and both bifurcated branches (Figure 4, Figure 5, Figure 6, Figure 7). Final angiogram showed successful exclusion of AAA without significant endoleak ( Movie 4). After the intervention, both puncture sites were sutured by two prepared Proglides at each site. |
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