
pmid: 22944573
Chronic contained rupture (CCR) of an abdominal aortic aneurysm is a rare condition, and differential diagnosis might be difficult. We present a clinical case of a hemodynamically stable octogenarian who presented with intermittent pain in the left lower abdomen. The patient had a history of diverticulitis, and 6 years ago, he had undergone endovascular abdominal aortic aneurysm repair (EVAR) with a Talent bifurcated prosthesis. Additionally, 20 days before his admission to our hospital, he had undergone a secondary iliac limb extension for treatment of post-EVAR rupture. On admission, abdominal plain radiography identified suprarenal fixation fracture as a possible reason for CCR, but computed tomographic angiography failed to confirm any endoleak or "active" bleeding and rupture. The patient received medication treatment for possible diverticulitis and was kept under close monitoring for suspected failure of recently performed secondary endovascular procedure and CCR. A day later, the abdominal pain symptoms worsened, and a new computed tomographic angiography confirmed the suspected CCR. The patient was treated successfully by "open" repair using a Y prosthesis. To our knowledge, this is the first reported case of post-EVAR CCR due to suprarenal fixation fatigue fracture. Lifelong post-EVAR follow-up with high level of both clinical and imaging diagnostic accuracy is essential for the early recognition and proper treatment of EVAR pitfalls.
Aged, 80 and over, Male, Reoperation, Endoleak, Aortic Rupture, Endovascular Procedures, Hemodynamics, Prosthesis Design, Aortography, Abdominal Pain, Blood Vessel Prosthesis, Prosthesis Failure, Blood Vessel Prosthesis Implantation, Foreign-Body Migration, Predictive Value of Tests, Chronic Disease, Humans, Stents, Tomography, X-Ray Computed, Aortic Aneurysm, Abdominal
Aged, 80 and over, Male, Reoperation, Endoleak, Aortic Rupture, Endovascular Procedures, Hemodynamics, Prosthesis Design, Aortography, Abdominal Pain, Blood Vessel Prosthesis, Prosthesis Failure, Blood Vessel Prosthesis Implantation, Foreign-Body Migration, Predictive Value of Tests, Chronic Disease, Humans, Stents, Tomography, X-Ray Computed, Aortic Aneurysm, Abdominal
| selected citations These citations are derived from selected sources. This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | 2 | |
| popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network. | Average | |
| influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | Average | |
| impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network. | Average |
