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Ruptured abdominal aortic aneurysm after endovascular repair

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1 Ruptured abdominal aortic aneurysm after endovascular repair
Victor M. Bernhard, MDa, R.Scott Mitchell, MDb, Jon S. Matsumura, MDc, David C. Brewster, MDd, Maria Decker, MDe, Patrick Lamparello, MDf, Dieter Raithel, MDg, Jack Collin, MA, MD, FRCSh  Journal of Vascular Surgery  Volume 35, Issue 6, Pages (June 2002) DOI: /mva Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

2 Fig. 1 Case 2. A, At 48 months, proximal fracture fragments (black arrows) that were present since 12 months after implant were stabile with minimal migration. Distal frame was tilted up because of posterior hook fracture with fragment separation (white arrows), and graft was kinked. B, CT scan cut through distal attachment site 1 year before rupture revealed widened distal neck with dye between graft and aortic wall at site of hook fracture posteriorly and partial separation of graft from aortic wall by clot. This limited attachment leak did not extend into AAA sac. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

3 Fig. 2 Case 4. A, Separation of distal fracture fragments from attachment frame was seen 31 months after implantation with development of bend in graft because of proximal migration of distal attachment site. B, Postrupture CT scan revealed dilated distal neck and separation of attachment system from aortic wall, surrounded by clot without endoleak. C, AAA diameter expanded from 4 × 4.1 cm 1 month before rupture to 4.9 × 6.1 cm. D, At time of rupture. Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

4 Fig. 3 Case 6. This CT scan showed ruptured aneurysm with dye extravasation into perianeurysmal hematoma (circle 1). Distal aortic neck was dilated at level of lower end of attachment frame (upper arrow) and was source of distal endoleak (lower arrow). Journal of Vascular Surgery  , DOI: ( /mva ) Copyright © 2002 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions


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