Open surgical repair remains the primary, albeit challenging, treatment option for ruptured giant abdominal aortic aneurysms when anatomic factors preclude endovascular repair.
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Open repair remains essential for ruptured giant AAAs with unsuitable anatomy; leaves open endovascular feasibility in this rare subgroup.
The rupture risk of abdominal aortic aneurysms (AAA) depends primarily on their diameter and increases substantially in large aneurysms. Only a few cases of giant AAAs, with a maximum diameter > 13 cm have been reported in the English literature. This case series report describes 3 cases of giant AAAs presented with rupture. All cases were managed with open surgical repair, since anatomic factors prevented us from choosing an endovascular approach. The huge size of the aneurysm, the short length of the neck and the dislodgement of abdominal organs, that may be densely adhered to its surface with fistula formation, make surgery of this entity very challenging. Open repair of giant AAAs is often the only available treatment, though not always with good results.
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Maras et al. (2009) studied this question.
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