REPORT A CASE OF ENDOVASCULAR AORTIC REPAIR FOR ABDOMINAL AORTIC ANEURYSM WITH HOSTILE NECK ANATOMY

Lân Hiếu Nguyễn, Văn Tú Lê, Văn Nhơn Bùi, Việt Dũng Trần

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Abstract

Abdominal aortic aneurysm (AAA) is a common and dangerous cardiovascular disease. There are currently two methods for treating AAA: surgery and endovascular abdominal aortic aneurysm repair (EVAR). In cases of AAA with a highly angulated aneurysm neck, it will be difficult to proceed with EVAR, and surgery will often be required for treatment. This article describes a case of successful EVAR in a patient with a highly angulated aneurysm neck, who is a 78-year-old female with a large fusiform aneurysm of the infrarenal abdominal aorta with a very angulated aneurysm neck angle (120 degrees), accompanied with severe 3-vessel coronary artery disease, for which surgery to replace the abdominal aorta may bring high risk. After careful assessment, we decided to proceed with EVAR for the patient, and the procedure has been done successfully.

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References

1. Svetlikov AV. Unknown pages in the history of vascular stent grafting. J Vasc Surg. 2014;59(3): 865-868. doi:10.1016/j.jvs.2013.11.067
2. AbuRahma AF, Campbell JE, Mousa AY, et al. Clinical outcomes for hostile versus favorable aortic neck anatomy in endovascular aortic aneurysm repair using modular devices. J Vasc Surg. 2011; 54(1): 13-21. doi:10.1016/ j.jvs.2010.12.010
3. Choke E, Munneke G, Morgan R, et al. Outcomes of Endovascular Abdominal Aortic Aneurysm Repair in Patients with Hostile Neck Anatomy. Cardiovasc Intervent Radiol. 2006; 29(6):975-980. doi:10.1007/s00270-006-0011-1
4. Stather PW, Sayers RD, Cheah A, Wild JB, Bown MJ, Choke E. Outcomes of Endovascular Aneurysm Repair in Patients with Hostile Neck Anatomy. Eur J Vasc Endovasc Surg. 2012;44(6): 556-561. doi:10.1016/j.ejvs.2012.10.003
5. Jordan WD, Ouriel K, Mehta M, et al. Outcome-based anatomic criteria for defining the hostile aortic neck. J Vasc Surg. 2015;61(6):1383-1390.e1. doi:10.1016/j.jvs.2014.12.063
6. Gallitto E, Gargiulo M, Freyrie A, et al. Results of standard suprarenal fixation endografts for abdominal aortic aneurysms with neck length ≤10 mm in high-risk patients unfit for open repair and fenestrated endograft. J Vasc Surg. 2016; 64(3): 563-570.e1. doi: 10.1016/ j.jvs.2016.02.018
7. Quinn AA, Mehta M, Teymouri MJ, et al. The incidence and fate of endoleaks vary between ruptured and elective endovascular abdominal aortic aneurysm repair. J Vasc Surg. 2017;65(6): 1617-1624. doi:10.1016/ j.jvs.2016.10.092
8. Gargiulo M, Gallitto E, Wattez H, et al. Outcomes of endovascular aneurysm repair performed in abdominal aortic aneurysms with large infrarenal necks. J Vasc Surg. 2017; 66(4):1065-1072. doi:10.1016/j.jvs.2017.01.066
9. Kim TH, Jang HJ, Choi YJ, Lee CK, Kwon SW, Shim WH. Kilt Technique as an Angle Modification Method for Endovascular Repair of Abdominal Aortic Aneurysm with Severe Neck Angle. Ann Thorac Cardiovasc Surg. 2017; 23(2):96-103. doi:10.5761/atcs.oa.16-00206
10. Verhoeven ELG, Vourliotakis G, Bos WTGJ, et al. Fenestrated Stent Grafting for Short-necked and Juxtarenal Abdominal Aortic Aneurysm: An 8-Year Single-centre Experience. Eur J Vasc Endovasc Surg. 2010;39(5): 529-536. doi:10. 1016/j.ejvs.2010.01.004