Key result
Emergent endovascular aneurysm repair was successfully performed in a hemodynamically unstable patient with a ruptured abdominal aortic aneurysm, leading to an uneventful recovery and discharge on post-operative day 3.
Case Report (n=1)
No
This case demonstrates that emergent endovascular aneurysm repair (EVAR) can be successfully performed in hemodynamically unstable patients with ruptured abdominal aortic aneurysms.
Hypothesis-generating for emergent EVAR in unstable ruptured AAA; prospective trials needed before practice change.
Ruptured aortic aneurysm has a surgical mortality ranging from 50%-70%, one of the highest rates of all vascular emergencies [1-5]. Less invasive approaches to repair have been developed that could potentially improve these statistics [1,5-7]. Endovascular aneurysm repair (EVAR) is a minimally invasive approach that may be an alternative to open surgical repair for select cases of ruptured aortic aneurysms [1,5]. Unfortunately, the role of EVAR in patients with acute rupture of an abdominal aneurysm is not clear, especially for patients that are hemodynamically unstable [1,8-10]. The literature is limited regarding use of EVAR in this population of patients. We present a case of the successful use of EVAR for an emergent repair in a hypotensive hemodynamically unstable patient with an acutely ruptured abdominal aortic aneurysm (AAA).
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Basile et al. (2013) conducted a case report in Ruptured hypotensive abdominal aortic aneurysm (n=1). Emergent endovascular aneurysm repair (EVAR) was evaluated on Survival and recovery. Emergent endovascular aneurysm repair was successfully performed in a hemodynamically unstable patient with a ruptured abdominal aortic aneurysm, leading to an uneventful recovery and discharge on post-operative day 3.
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