Endovascular repair of an abdominal aortic aneurysm in a patient with stenosis of bilateral common iliac artery stents

Leo Daab, Gilbert Aidinian, Michael A. Weber, Ronald J. Kembro, Patrick R. Cook

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: The explosion in endovascular interventions for peripheral vascular disease has resulted in procedures being used by a multitude of specialties. Nonvascular surgeons performing these interventions can create scenarios that may make future vascular interventions difficult. In this article, we present a case report illustrating this point. Methods: A 68-year-old man with severe chronic obstructive pulmonary disease, coronary artery disease with prior myocardial infarction, and multiple abdominal operations presented with an abdominal aortic aneurysm. In our opinion, this patient was at a prohibitive operative risk for open repair. Review of his imaging results revealed a 6.7-cm infrarenal aneurysm with bilateral common iliac artery (CIA) stents (right: 8 mm; left: 6 mm) and 6-mm self-expanding stents extending from the right external iliac artery through the common femoral artery. A Cook Zenith Renu (30 × 108 mm) graft (Cook Medical Inc., Bloomington, IN) was advanced after serial dilation and balloon angioplasty of the stenotic right CIA stent. Left brachial access was used for arteriographic imaging. The left common femoral artery was accessed and the left CIA was coil-embolized to prevent backbleeding. A femoro-femoral artery crossover bypass was then performed after segmental resection of the right common femoral artery stent. Results: The patient tolerated the procedure well and was discharged home on postoperative day 3. Subsequent postoperative computed tomography arteriogram after 1 month showed palpable pulses and no evidence of endoleak with flow in the femoro-femoral graft on clinical exam. Conclusions: This case demonstrates an endovascular intervention which limited the potential options available for aneurysm repair. Similar problems may become increasingly common as more providers offer endovascular interventions, thus emphasizing the importance of a collaborative approach to the patient with complex aorto-iliac occlusive disease and abdominal aortic aneurysm. It is the duty of the vascular surgeon to offer his vital expertise and leadership in the care of these patients.

Original languageEnglish (US)
Pages (from-to)133.e9-133.e12
JournalAnnals of Vascular Surgery
Volume25
Issue number1
DOIs
StatePublished - Jan 1 2011
Externally publishedYes

Fingerprint

Iliac Artery
Abdominal Aortic Aneurysm
Femoral Artery
Stents
Pathologic Constriction
Aneurysm
Blood Vessels
Transplants
Endoleak
Balloon Angioplasty
Peripheral Vascular Diseases
Explosions
Thigh
Chronic Obstructive Pulmonary Disease
Dilatation
Patient Care
Arm
Tomography
Surgeons

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Endovascular repair of an abdominal aortic aneurysm in a patient with stenosis of bilateral common iliac artery stents. / Daab, Leo; Aidinian, Gilbert; Weber, Michael A.; Kembro, Ronald J.; Cook, Patrick R.

In: Annals of Vascular Surgery, Vol. 25, No. 1, 01.01.2011, p. 133.e9-133.e12.

Research output: Contribution to journalArticle

Daab, Leo ; Aidinian, Gilbert ; Weber, Michael A. ; Kembro, Ronald J. ; Cook, Patrick R. / Endovascular repair of an abdominal aortic aneurysm in a patient with stenosis of bilateral common iliac artery stents. In: Annals of Vascular Surgery. 2011 ; Vol. 25, No. 1. pp. 133.e9-133.e12.
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