Ruptured abdominal aortic aneurysm after endovascular repair

Abstract

Introduction. An aneurysm is a localized, permanent dilation of an arterial blood vessel with a diameter greater than 50% of the usual diameter for that aortic segment. It is treated with endovascular stent graft placement or open surgery. Endovascular stent grafting of the abdominal aorta has become popular as an elective treatment. but one of the complications is increased aneurysm diameter that may lead to rupture. Case Series. This case series reviews open reconstructive surgery of ruptured abdominal aortic aneurysms in three patients treated with endovascular repair. The diameter of the aneurysm increased due to endoleak or stent graft migration, leading to rupture. Due to the inability to extract the stent graft in two patients, the graft was transversely cut at the proximal part, where upper anastomosis was created using a Dacron graft prosthesis. Conclusion. Regular annual controls for the rest of patients lives are of great importance in order to avoid fatal complications after endovascular aneurysm repair. One of the methods after the abdominal aortic rupture after endovascular stent graft treatment that significantly shortens the duration of the surgery and gives a more stable upper anastomosis, is transverse stent graft cut in the proximal part. Complete prevention remains a challenge because a rupture may occur even if the abnormalities are not evident. The ultimate goal is to increase the survival rate after the ruptured abdominal aortic aneurysm.