scholarly journals Ruptured Common Femoral Artery Aneurysm or Abdominal Aortic Aneurysm?

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Tetsuya Niino ◽  
Satoshi Unosawa ◽  
Haruka Kimura
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Femoral Artery ◽  
Groin Pain ◽  
Artery Aneurysm ◽  
Common Femoral Artery ◽  
Retroperitoneal Hematoma ◽  
Left Groin ◽  
Abdominal Aortic ◽  
The Common

We encountered a patient with a large retroperitoneal hematoma due to rupture of a common femoral artery aneurysm. A 77-year-old man was transferred to our hospital with left groin pain and shock. Computed tomography demonstrated a large retroperitoneal hematoma involving the left iliofemoral segment with extravasation of contrast into the left groin from a ruptured left common femoral artery aneurysm. The patient also had an abdominal aortic aneurysm. Reconstruction of the common femoral artery with a graft was performed successfully. The patient had an uneventful postoperative course and subsequently underwent Y-graft replacement of the abdominal aortic aneurysm.

scholarly journals Thoracic Endovascular Aortic Repair With a Right Thoracotomy Approach: a Case Report

2021 ◽  
Author(s):  
Hideki Tanioka ◽  
Takanori Shibukawa ◽  
Keiji Iwata
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aorta ◽  
Femoral Artery ◽  
Common Femoral Artery ◽  
Access Route ◽  
Descending Thoracic Aorta ◽  
Descending Aorta ◽  
Right Thoracotomy ◽  
Abdominal Aortic ◽  
The Common

Abstract Background: The common femoral artery is usually the preferred access route for thoracic endovascular aortic repair (TEVAR). However, if access from the common femoral artery is challenging, other routes must be considered. We report a case of TEVAR performed by approaching the descending thoracic aorta with a right thoracotomy and using the descending thoracic aorta as an access route. Case presentation: A 70-year-old female was diagnosed with a descending thoracic aortic aneurysm (65 mm in diameter), a thoracoabdominal aneurysm (54 mm in diameter), and an abdominal aortic aneurysm (49 mm in diameter). Since the patient had severe chronic obstructive pulmonary disease, one-stage replacement of the thoracoabdominal aortic aneurysm was contraindicated and TEVAR on the descending aorta was selected. A strong tortuous section of the aorta—from the descending aorta to the abdominal aorta—hampered endovascular access to the site from the common femoral artery. A TEVAR approach from the abdominal aorta was also considered; however, an abdominal aortic aneurysm and a transverse colon loop stoma from an earlier surgery presented challenges to this technique. We chose to access the descending thoracic aorta with a thoracotomy from the right 6th intercostal space for TEVAR, because the access route that is not affected by the meandering of the aorta is considered to be the descending aorta with a right thoracotomy. The patient’s postoperative course was uneventful after the stent graft was placed. No complications were detected with postoperative contrast-enhanced computed tomography (CT). Conclusions: Our findings suggest that TEVAR can be performed by approaching the descending aorta from a right thoracotomy, if variations of vascular anatomy interfere with the more commonly used femoral artery approach.

Emergency endovascular treatment of a ruptured internal iliac artery aneurysm long after abdominal aortic aneurysm surgical repair

VASA ◽  
2009 ◽  
Vol 38 (1) ◽  
pp. 91-93 ◽  
Author(s):  
Borioni ◽  
De Luca ◽  
Maspes ◽  
Sciuto ◽  
Garofalo
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Treatment ◽  
Iliac Artery ◽  
Surgical Repair ◽  
Internal Iliac Artery ◽  
Artery Aneurysm ◽  
Emergency Setting ◽  
Abdominal Aortic ◽  
Internal Iliac

The purpose of this report is to describe the endovascular exclusion of an internal iliac artery (IIA) aneurysm in emergency setting, long after abdominal aortic aneurysm surgical repair. An 85-year-old male presented with a contained rupture of a huge IIA aneurysm, ten years after aortoiliac bifurcated grafting. Because of poor clinical conditions an emergency endovascular treatment was planned. A stent-graft was positioned from the proximal right branch of the bifurcated surgical prosthesis to the distal external iliac artery, covering the hypogastric aneurysm neck. One month after the procedure, CT scan demonstrated the complete exclusion of the aneurysm. Endovascular treatment of IIA aneurysms is an excellent option to reduce perioperative morbidity and mortality in high risk patients, particularly in an emergency setting.

Endovascular Abdominal Aortic Aneurysm Repair through a Persistent Sciatic Artery

2015 ◽  
Vol 10 (5) ◽  
pp. 354-356
Author(s):  
Rajesh Ramanathan ◽  
Michelle L. DesChamplain ◽  
Derek R. Brinster
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Femoral Artery ◽  
Arterial System ◽  
Persistent Sciatic Artery ◽  
Infrarenal Aortic Aneurysm ◽  
Open Operation ◽  
Abdominal Aortic ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Conventional access for endovascular infrarenal aortic aneurysm repair is through the femoral artery. In rare circumstances, an anomalous persistent sciatic artery may replace the femoral arterial system as the main blood supply of the lower extremity. We report the case of a 64-year-old woman with a rapidly expanding infrarenal abdominal aortic aneurysm. Preoperative computed tomography revealed a right persistent sciatic artery with an ipsilateral atrophic femoral artery. Her aortic aneurysm was successfully repaired using an endovascular approach with access through the right persistent sciatic artery and contralateral femoral artery. A persistent sciatic artery can be used as an access for endovascular treatment of an infrarenal aortic aneurysm. This technique can be extrapolated to the treatment of distal or contralateral aneurysms, precluding the need for open operation.

scholarly journals Ex vivo repair of renal artery aneurysm associated with surgical treatment of abdominal aortic aneurysm

2004 ◽  
Vol 132 (7-8) ◽  
pp. 250-253
Author(s):  
Dusan Kostic ◽  
Lazar Davidovic ◽  
Drago Milutinovic ◽  
Radomir Sindjelic ◽  
Marko Dragas ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Renal Artery ◽  
Ex Vivo ◽  
Artery Aneurysm ◽  
Ptfe Graft ◽  
Dacron Graft ◽  
Renal Artery Aneurysm ◽  
Abdominal Aortic ◽  
The Right

INTRODUCTION Renal artery aneurysms is relatively uncommon with reported incidence ranges from 0.3% to 1%. However, considering all visceral artery aneurysms the percentage of renal artery aneurysms is relatively high between 15-25%. The distal forms of renal artery aneurysms sometimes require "ex vivo" reconstruction and kidney autotransplantation. CASE REPORT A 75-year-old male presented with the right abdominal and back pain. He suffered from a long history of arterial hypertension and chronic renal failure over the last few months (urea blood = 19.8 mmol/l; creatinine = 198 mmol/l). Duplex ultrasonography showed abdominal aortic aneurysm. Subsequent translumbarangiography revealed juxtarenal abdominal aortic aneurysm associated with distal right renal artery aneurysm. The operation was performed under combined thoracic epidural analgesia and general anesthesia using transperitoneal approach. After the laparotomy, the ascending colon was mobilized and reflected medially followed by Kocher maneuver. The result was visualization of the anterior aspect of the right kidney, the collecting system, ureter as well as the right renal vein and artery with large saccular aneurysm located distally. After mobilization of the renal vessels and careful dissection of the ureter, the kidney was explanted. The operation was continued by two surgical teams. The first team performed abdominal aortic aneurysm resection and reconstruction with bifurcated Dacron graft. The second team performed ex vivo reparation of renal artery aneurysm. All time during the explantation, the kidney was perfused by Collins' solution. The saccular right renal artery aneurysm 4 cm in diameter was located at the kidney hilus at the first bifurcation. Three branches originated from the aneurysm. The aneurysm was resected completely. The longest and widest of three branches arising from the aneurysmal sac was end-to-end anastomized with 6 mm PTFE graft. After this intervention, one of shorter arteries was implanted into the long artery, and another one into PTFE graft. After 30 minutes of explanation, autotransplantation of the kidney into the right iliac fossa was performed. The right renal vein was implanted into the inferior vein cava, and PTFE graft into the right limb of Dacron graft. Immediately following the completion of both anastomoses, large volume of urine was evident. Finally, ureteneocystostomy was performed with previous insertion of double "J" catheter. In the immediate postoperative period, renal function was restored to normal, while postoperative angiography revealed all patent grafts. DISCUSSION The most common causes of renal artery aneurysms are arteriosclerosis, as in our case, and fibro-muscular dysplasia. Very often, renal artery aneurysms are asymptomatic and discovered only during angiography in patients with aneurysmal and occlusive aortic disease. Other cases include: arterial hypertension, groin pain and acute or chronic renal failure. Due to relatively small number of evaluated cases, the risk of aneurysmal rupture is not known. According to some authors, the overall rupture rate of renal artery aneurysm is 5%, however, the rupture risk becomes higher in young pregnant woman. Several standard surgical procedures are available for the repair of renal artery aneurysms. These include saphenous vein angioplasty, bypass grafting, as well as ex vivo reconstruction with reimplantation or autotransplantation. Furthermore, interventional embolization therapy, as well as endovascular treatment with ePTFE covered stent, or autologous vein-coverage stent graft, have been also reported to be successful. CONCLUSION The major indications for surgical treatment of renal artery aneurysms are to eliminate the source of thromboembolism which leads to fixed renal hypertension and kidney failure, as well as prevention of aneurysmal rupture.

scholarly journals A case of inflammatory abdominal aortic aneurysm diagnosed clinically with left common iliac artery aneurysm.

Ensho ◽  
2000 ◽  
Vol 20 (5) ◽  
pp. 619-623
Author(s):  
Hiroaki Inamura ◽  
Motohiro Kurosawa ◽  
Jun-ichiro Morioka ◽  
Rieko Nakagami ◽  
Yutaka Mizushima ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Iliac Artery ◽  
Common Iliac Artery ◽  
Artery Aneurysm ◽  
Iliac Artery Aneurysm ◽  
Left Common Iliac Artery ◽  
Abdominal Aortic ◽  
Common Iliac Artery Aneurysm ◽  
Inflammatory Abdominal Aortic Aneurysm
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