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Updated: Jan 29, 2026

Porcine Model of Infrarenal Abdominal Aortic Aneurysm
Published on: November 21, 2019
Repeat Rupture of a Giant Abdominal Aortic Aneurysm after EVAR
Jorn P Meekel1,2, Theodorus G van Schaik1,2, Michiel L P van Zeeland3
1Department of Vascular Surgery, Amsterdam University Medical Centres, VU University Medical Center, Amsterdam, the Netherlands.
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.
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