Repeat Rupture of a Giant Abdominal Aortic Aneurysm after EVAR

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Introduction: Ruptured abdominal aortic aneurysms (AAAs) are known to be associated with high fatal outcomes. Giant AAAs are often defined as having a maximum diameter over 13 cm. Large AAAs over 8 cm have demonstrated a yearly rupture rate of 30–50%, which explains the rarity of giant AAAs. Endovascular repair of ruptured AAAs (rAAAs) is increasingly advocated because of the shorter hospital stay and fewer post-operative complications. Nonetheless, outcomes regarding mortality and cost-effectiveness show a large variability and long-term outcomes are lacking. Few data have been published on treatment of giant AAAs and rAAAs; however, open surgery is generally the preferred option. Report: An 83 year old presented to the Emergency Department with a history of ruptured abdominal aortic aneurysm treated with an aorto-uni-iliac endograft and a femorofemoral crossover bypass. During follow up, this was complicated by a symptomatic type III endoleak, which was treated by endovascular repair. During the current admission, he presented with a re-rupture of his former aneurysm, which now was 18 cm diameter because of a type IA endoleak. Open surgical repair was performed and the post-operative course was without complications. Discussion: The current case underlines the value of vascular surgeons being able to perform both open and endovascular surgery in rAAA.
Original languageEnglish
Pages (from-to)15-17
Number of pages3
JournalEJVES Short Reports
Volume42
DOIs
Publication statusPublished - 1 Jan 2019

Cite this

@article{3de6bd2e2a7d4a49ab5811a234f895bb,
title = "Repeat Rupture of a Giant Abdominal Aortic Aneurysm after EVAR",
abstract = "Introduction: Ruptured abdominal aortic aneurysms (AAAs) are known to be associated with high fatal outcomes. Giant AAAs are often defined as having a maximum diameter over 13 cm. Large AAAs over 8 cm have demonstrated a yearly rupture rate of 30–50{\%}, which explains the rarity of giant AAAs. Endovascular repair of ruptured AAAs (rAAAs) is increasingly advocated because of the shorter hospital stay and fewer post-operative complications. Nonetheless, outcomes regarding mortality and cost-effectiveness show a large variability and long-term outcomes are lacking. Few data have been published on treatment of giant AAAs and rAAAs; however, open surgery is generally the preferred option. Report: An 83 year old presented to the Emergency Department with a history of ruptured abdominal aortic aneurysm treated with an aorto-uni-iliac endograft and a femorofemoral crossover bypass. During follow up, this was complicated by a symptomatic type III endoleak, which was treated by endovascular repair. During the current admission, he presented with a re-rupture of his former aneurysm, which now was 18 cm diameter because of a type IA endoleak. Open surgical repair was performed and the post-operative course was without complications. Discussion: The current case underlines the value of vascular surgeons being able to perform both open and endovascular surgery in rAAA.",
keywords = "EVAR, Endoleak, Giant abdominal aorta aneurysm, Open repair, Re-rupture",
author = "Meekel, {Jorn P.} and {van Schaik}, {Theodorus G.} and {van Zeeland}, {Michiel L. P.} and Yeung, {Kak K.} and Hoksbergen, {Arjan W. J.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.ejvssr.2018.12.001",
language = "English",
volume = "42",
pages = "15--17",
journal = "EJVES Short Reports",
issn = "2405-6553",
publisher = "Elsevier Ltd",

}

TY - JOUR

T1 - Repeat Rupture of a Giant Abdominal Aortic Aneurysm after EVAR

AU - Meekel, Jorn P.

AU - van Schaik, Theodorus G.

AU - van Zeeland, Michiel L. P.

AU - Yeung, Kak K.

AU - Hoksbergen, Arjan W. J.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Introduction: Ruptured abdominal aortic aneurysms (AAAs) are known to be associated with high fatal outcomes. Giant AAAs are often defined as having a maximum diameter over 13 cm. Large AAAs over 8 cm have demonstrated a yearly rupture rate of 30–50%, which explains the rarity of giant AAAs. Endovascular repair of ruptured AAAs (rAAAs) is increasingly advocated because of the shorter hospital stay and fewer post-operative complications. Nonetheless, outcomes regarding mortality and cost-effectiveness show a large variability and long-term outcomes are lacking. Few data have been published on treatment of giant AAAs and rAAAs; however, open surgery is generally the preferred option. Report: An 83 year old presented to the Emergency Department with a history of ruptured abdominal aortic aneurysm treated with an aorto-uni-iliac endograft and a femorofemoral crossover bypass. During follow up, this was complicated by a symptomatic type III endoleak, which was treated by endovascular repair. During the current admission, he presented with a re-rupture of his former aneurysm, which now was 18 cm diameter because of a type IA endoleak. Open surgical repair was performed and the post-operative course was without complications. Discussion: The current case underlines the value of vascular surgeons being able to perform both open and endovascular surgery in rAAA.

AB - Introduction: Ruptured abdominal aortic aneurysms (AAAs) are known to be associated with high fatal outcomes. Giant AAAs are often defined as having a maximum diameter over 13 cm. Large AAAs over 8 cm have demonstrated a yearly rupture rate of 30–50%, which explains the rarity of giant AAAs. Endovascular repair of ruptured AAAs (rAAAs) is increasingly advocated because of the shorter hospital stay and fewer post-operative complications. Nonetheless, outcomes regarding mortality and cost-effectiveness show a large variability and long-term outcomes are lacking. Few data have been published on treatment of giant AAAs and rAAAs; however, open surgery is generally the preferred option. Report: An 83 year old presented to the Emergency Department with a history of ruptured abdominal aortic aneurysm treated with an aorto-uni-iliac endograft and a femorofemoral crossover bypass. During follow up, this was complicated by a symptomatic type III endoleak, which was treated by endovascular repair. During the current admission, he presented with a re-rupture of his former aneurysm, which now was 18 cm diameter because of a type IA endoleak. Open surgical repair was performed and the post-operative course was without complications. Discussion: The current case underlines the value of vascular surgeons being able to perform both open and endovascular surgery in rAAA.

KW - EVAR

KW - Endoleak

KW - Giant abdominal aorta aneurysm

KW - Open repair

KW - Re-rupture

UR - http://www.scopus.com/inward/record.url?scp=85060534261&partnerID=8YFLogxK

U2 - 10.1016/j.ejvssr.2018.12.001

DO - 10.1016/j.ejvssr.2018.12.001

M3 - Article

VL - 42

SP - 15

EP - 17

JO - EJVES Short Reports

JF - EJVES Short Reports

SN - 2405-6553

ER -