Cited 2 times since 2019 (0.3 per year) source: EuropePMC EJVES short reports, Volume 42, 21 3 2019, Pages 15-17 Repeat Rupture of a Giant Abdominal Aortic Aneurysm after EVAR. Meekel JP, van Schaik TG, van Zeeland MLP, Yeung KK, Hoksbergen AWJ
Introduction
Ruptured abdominal aortic aneurysms (AAAs) are known to be associated with high fatal outcomes. Giant AAAs are often defined as having a maximum diameter over 13 cm. Large AAAs over 8 cm have demonstrated a yearly rupture rate of 30-50%, which explains the rarity of giant AAAs. Endovascular repair of ruptured AAAs (rAAAs) is increasingly advocated because of the shorter hospital stay and fewer post-operative complications. Nonetheless, outcomes regarding mortality and cost-effectiveness show a large variability and long-term outcomes are lacking. Few data have been published on treatment of giant AAAs and rAAAs; however, open surgery is generally the preferred option.
Report
An 83 year old presented to the Emergency Department with a history of ruptured abdominal aortic aneurysm treated with an aorto-uni-iliac endograft and a femorofemoral crossover bypass. During follow up, this was complicated by a symptomatic type III endoleak, which was treated by endovascular repair. During the current admission, he presented with a re-rupture of his former aneurysm, which now was 18 cm diameter because of a type IA endoleak. Open surgical repair was performed and the post-operative course was without complications.
Discussion
The current case underlines the value of vascular surgeons being able to perform both open and endovascular surgery in rAAA.
