Case Report: A Revolutionary Device Using Bidirectional Endovascular Aortic Repair (B-EVAR) in Impending Rupture Abdominal Aortic Aneurysm

<ns3:p>Background Abdominal Aortic Aneurysm (AAA) is an aortic dilation exceeding 3 cm, common in the elderly. Ruptured AAA (rAAA) has a 90% mortality rate. EVAR is preferred over open surgery but is hindered by challenging contralateral gate cannulation (CGC), increasing procedure and fluoroscopy times. Case Presentation A 57-year-old male with a history of hypertension, dyslipidemia, prediabetes, smoking, and alcohol use presented with acute severe abdominal pain. CT angiography revealed a 77.9 mm aneurysm indicating an impending rupture. With stable hemodynamics, an emergency EVAR using the Taofan & Kang bidirectional endovascular aortic repair (T&K B-EVAR) device was performed. The procedure took 59 minutes with a fluoroscopy time of 21 minutes and 55 seconds. The innovative B-EVAR design enabled rapid CGC in under one minute, significantly reducing overall procedure time. Postoperative imaging confirmed proper stent placement without endoleaks or stent migration, and the patient was discharged in stable condition after five days. Conclusion The T&K B-EVAR device offers significant advantages in emergent AAA cases by simplifying CGC, reducing procedure and fluoroscopy times, and improving patient outcomes. This case highlights its potential for broader clinical use in both elective and emergency settings.</ns3:p>