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Updated: Sep 11, 2025

Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
Published on: August 1, 2025
EVAR solution for acute thrombosis of abdominal aortic aneurysm: A case report and literature review
Xiping Xu1, Shumeng Yang, Jihua Shi
1Department of Vascular Surgery, Linyi People's Hospital, Shandong Second Medical University, Linyi, Shandong, China.
Rationale:
Acute thrombosis of an abdominal aortic aneurysm (ATAAA) is a rare but catastrophic complication of abdominal aortic aneurysm. For inherently high-risk ATAAA, a more invasive open surgical approach is associated with increased mortality.
Patient Concerns:
A 68-year-old male presented with sudden-onset severe back and lower limb pain persisting for over 9 hours. Physical examination revealed a pulsatile abdominal mass and bilateral lower limb ischemia.
Diagnoses:
Computed tomography angiography revealed a 4.5 cm infrarenal abdominal aortic aneurysm with acute thrombosis extending into both common iliac arteries, confirming the diagnosis of ATAAA.
Interventions:
The proximal neck anatomy of the aneurysm was suitable for endovascular aneurysm repair (EVAR); accordingly, balloon thrombectomy followed by EVAR was performed.
Outcomes:
Complete revascularization was achieved. The patient was discharged on postoperative day 4 and remained asymptomatic at the 2-year follow-up.
Lessons:
Only 5 cases of ATAAA treated with an endovascular approach have been reported. Although further validation is needed, EVAR shows promise as a safe and effective treatment for selected cases, potentially reducing the high mortality rate associated with this condition.
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