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Successful Percutaneous Endovascular Repair in a Very Large, Symptomatic, Non-ruptured Abdominal Aortic Aneurysm with Severe Neck Angulation
Percutaneous endovascular aneurysm repair (PEVAR) is a minimally invasive treatment option for patients with abdominal aortic aneurysms (AAA). PEVAR allows for the lower incidence of vascular access site complications and decreased procedure time, yet the utility of this technique depends on the ana...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6741388/ https://www.ncbi.nlm.nih.gov/pubmed/31523556 http://dx.doi.org/10.7759/cureus.5125 |
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author | White, Bradley M Meyer, Dustin L Kumar, Aswin Anderson, Curtis L |
author_facet | White, Bradley M Meyer, Dustin L Kumar, Aswin Anderson, Curtis L |
author_sort | White, Bradley M |
collection | PubMed |
description | Percutaneous endovascular aneurysm repair (PEVAR) is a minimally invasive treatment option for patients with abdominal aortic aneurysms (AAA). PEVAR allows for the lower incidence of vascular access site complications and decreased procedure time, yet the utility of this technique depends on the anatomical characteristics of the aneurysm. A detailed evaluation of the access site vessels and aneurysm neck anatomy are critical for standard patient and device selection. An 84-year-old male presented to our institution with the sudden onset of abdominal pain and confusion. Subsequent imaging demonstrated the presence of a 9.5 cm fusiform, infrarenal abdominal aortic aneurysm with a greater than 60-degree neck angulation and bilateral common iliac aneurysms. The patient underwent percutaneous endovascular aneurysm repair (PEVAR), and a type IB endoleak seen at the end of the case was treated successfully. At the one-year follow-up, the patient remained asymptomatic with the AAA stable in size. This case represents the largest reported symptomatic unruptured AAA repaired with a completely percutaneous technique to date. Building up the stent-graft from the bifurcation with a unibody modular device may allow for support to address the severe angulation of a very hostile neck. PEVAR is a viable option in patients with symptomatic AAA and can be performed despite severe aneurysm neck angulation. |
format | Online Article Text |
id | pubmed-6741388 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-67413882019-09-15 Successful Percutaneous Endovascular Repair in a Very Large, Symptomatic, Non-ruptured Abdominal Aortic Aneurysm with Severe Neck Angulation White, Bradley M Meyer, Dustin L Kumar, Aswin Anderson, Curtis L Cureus Cardiac/Thoracic/Vascular Surgery Percutaneous endovascular aneurysm repair (PEVAR) is a minimally invasive treatment option for patients with abdominal aortic aneurysms (AAA). PEVAR allows for the lower incidence of vascular access site complications and decreased procedure time, yet the utility of this technique depends on the anatomical characteristics of the aneurysm. A detailed evaluation of the access site vessels and aneurysm neck anatomy are critical for standard patient and device selection. An 84-year-old male presented to our institution with the sudden onset of abdominal pain and confusion. Subsequent imaging demonstrated the presence of a 9.5 cm fusiform, infrarenal abdominal aortic aneurysm with a greater than 60-degree neck angulation and bilateral common iliac aneurysms. The patient underwent percutaneous endovascular aneurysm repair (PEVAR), and a type IB endoleak seen at the end of the case was treated successfully. At the one-year follow-up, the patient remained asymptomatic with the AAA stable in size. This case represents the largest reported symptomatic unruptured AAA repaired with a completely percutaneous technique to date. Building up the stent-graft from the bifurcation with a unibody modular device may allow for support to address the severe angulation of a very hostile neck. PEVAR is a viable option in patients with symptomatic AAA and can be performed despite severe aneurysm neck angulation. Cureus 2019-07-11 /pmc/articles/PMC6741388/ /pubmed/31523556 http://dx.doi.org/10.7759/cureus.5125 Text en Copyright © 2019, White et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Cardiac/Thoracic/Vascular Surgery White, Bradley M Meyer, Dustin L Kumar, Aswin Anderson, Curtis L Successful Percutaneous Endovascular Repair in a Very Large, Symptomatic, Non-ruptured Abdominal Aortic Aneurysm with Severe Neck Angulation |
title | Successful Percutaneous Endovascular Repair in a Very Large, Symptomatic, Non-ruptured Abdominal Aortic Aneurysm with Severe Neck Angulation |
title_full | Successful Percutaneous Endovascular Repair in a Very Large, Symptomatic, Non-ruptured Abdominal Aortic Aneurysm with Severe Neck Angulation |
title_fullStr | Successful Percutaneous Endovascular Repair in a Very Large, Symptomatic, Non-ruptured Abdominal Aortic Aneurysm with Severe Neck Angulation |
title_full_unstemmed | Successful Percutaneous Endovascular Repair in a Very Large, Symptomatic, Non-ruptured Abdominal Aortic Aneurysm with Severe Neck Angulation |
title_short | Successful Percutaneous Endovascular Repair in a Very Large, Symptomatic, Non-ruptured Abdominal Aortic Aneurysm with Severe Neck Angulation |
title_sort | successful percutaneous endovascular repair in a very large, symptomatic, non-ruptured abdominal aortic aneurysm with severe neck angulation |
topic | Cardiac/Thoracic/Vascular Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6741388/ https://www.ncbi.nlm.nih.gov/pubmed/31523556 http://dx.doi.org/10.7759/cureus.5125 |
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