A 76-year-old male was admitted to our hospital for the management of progressively enlarging infrarenal abdominal aortic aneurysm (AAA). 9 years ago, his AAA was initially detected on abdominal CT scan while he was evaluated for gastric cancer. The increase in the aneurysmal diameter was found by regular follow-up using computed tomography (CT). On the last CT scan, maximal aneurysmal diameter increased from 4.6 cm to 5.7 cm for 1 year. He had history of gastric cancer, asthma, stroke, hyperlipidemia and ischemic heart disease.
|
Vascular accesses were obtained by insertion of two 8 Fr sheathes into both femoral arteries, and aortography was performed via right femoral artery using a 5 Fr pigtail diagnostic catheter ( Movie 1). After the puncture sites were prepared to be closed using 2 8Fr Proglide for each site, we dilated the right femoral artery using 18 Fr sheath dilator and then inserted and deployed the Excluder Stent Graft System 23-12mm/140 mm from AAA to right common iliac artery ( Movie 2, Figure 3). An Excluder Contralateral limb (16-20mm/135 mm) was deployed at left common iliac artery (Figure 4) and an Excluder Contralateral limb (16-20mm/95mm) was deployed at right common iliac artery ( Movie 3, Figure 5). The balloon dilatation was performed via left and right femoral artery with a Tri-lobe balloon 34mm balloon at stent body and both bifurcated branches (Figure 6, Figure 7). Final angiogram showed successful exclusion of AAA without significant endoleak ( Movie 4). After the intervention, both puncture sites were closed by two prepared Proglides.
|
Leave a comment