Endovascular Management of Aortic Stump Blowout by Parallel Grafting and Coil Embolization of Visceral Aorta.

Vascular and endovascular surgery Pub Date : 2024-07-01 Epub Date: 2024-01-02 DOI:10.1177/15385744231225890
Hana Shafique, Kofi Quaye, Mitchell W Cox, Chandler A Long, Zachary F Williams
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Abstract

Aortic graft and endograft infections remain a significant source of morbidity and mortality after abdominal aortic aneurysm repair. With graft excision and extra-anatomic bypass, an infrarenal aortic stump remains which can have suture line dehiscence and catastrophic stump blowout. Treatment of this is extremely challenging, especially for severely co-morbid patients who cannot undergo major surgery, or in patients with a hostile abdomen. We present a case study of a 74-year-old male found to have an aortoenteric fistula (AEF). This case broadens operative options for this type of patient population by demonstrating an endovascular technique for addressing aortic stump blowout by parallel grafting and coil embolization of the visceral aorta.

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通过平行移植和内脏主动脉线圈栓塞对主动脉残端炸裂进行血管内治疗。
主动脉移植物和内移植物感染仍然是腹主动脉瘤修复术后发病率和死亡率的重要原因。在移植物切除和解剖外搭桥后,肾下主动脉残端仍然存在,这可能导致缝合线开裂和灾难性的残端破裂。这种情况的治疗极具挑战性,尤其是对于合并严重疾病、无法接受大手术的患者,或者腹部有敌意的患者。我们介绍了一例 74 岁男性主动脉瘘(AEF)的病例研究。该病例展示了一种通过平行移植和内脏主动脉线圈栓塞来解决主动脉残端喷血问题的血管内技术,从而拓宽了这类患者的手术选择范围。
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