Difficult EVAR

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Case Presentation - November 2012

W. Michael Park, MD


History

The patient is a 79 year old woman with an 8.7cm infrarenal abdominal aortic aneurysm (figure 1) with bilateral iliac arterial occlusion.

She was turned down for repair due to her medical comorbidities and inability to access her aorta for endovascular aneurysm repair (EVAR) due to her iliac arterial occlusions (figure 2). She was asymptomatic from her aneurysm, but did complain of calf claudication with walking short distances.

The CT scan, which was an outside study, showed the aneurysm to be saccular (figure 3) compounding the high risk of rupture already conferred by its large size. After reviewing the images, we decided that even with her medical comorbidities, the immediate and high risk of rupture and the feasibility of repair compelled us to recommend repair.

Click on images for a larger view

Figure 1 Figure 2 Figure 3

Reviewed: 11/13

Non-critical demographic information has been changed to protect the anonymity of the individual and no association with any actual patient is intended or should be inferred.

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