Endovascular Treatment of a Late Complication of an Open Repair of Abdominal Aortic Aneurysm - Abstract
Abdominal aortic aneurysms (AAA) are the most common type of aortic
aneurysms. Traditionally it has been treated by open surgical repair (OSR), but in the
last years endovascular repair (EVAR) became the first choice treatment in patients
with suitable anatomy. Although the mortality and morbidity are lower with EVAR,
late complications, such as endoleaks, remain a problem. Late complications after
OSR are less frequent than after EVAR, but they still occur. We report a case of a
patient with an uncommon late complication after OSR: limb occlusion of the Dacron
prosthesis of an aortobifemoral bypass 14 years after. The rescue was performed
by an unusual, but successful, urgent endovascular approach using intra-arterial
thrombolysis with recombinant tissue plasminogen activator(r-tPA) followed by covered
stents implantation in the Dacron limb prosthesis and balloon angioplasty in the origin
of a previous saphenous vein femoropopliteal bypass grafting. Late complications
after EVAR and OSR, as well as treatment options, are discussed here