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Aortic stump closure with a titanium permanent clamp: a useful emergency method
M Kobayashi1, M Matsushita, N Nishikimi
1First Department of Surgery, Nagoya University School of Medicine, Japan.
Insights
A permanent titanium clamp successfully closed a blown-out aortic stump in a patient with Behçet
Area of Science:
- Vascular Surgery
- Gastroenterology
Background:
- Behçet's disease presents complex surgical challenges, particularly in managing aortic complications.
- Previous interventions included prosthetic graft replacement for an abdominal aortic aneurysm and subsequent graft removal due to perigraft fluid collection.
Observation:
- A patient with Behçet's disease developed an aortoenteric fistula requiring emergency surgical intervention.
- The aortic stump, previously managed with sutures after graft removal, was identified as the source of the fistula.
Findings:
- Successful management of the aortoenteric fistula was achieved by utilizing a permanent titanium clamp for aortic stump closure.
- This approach provided a durable seal, preventing further complications.
Implications:
- Permanent titanium clamps may represent a viable alternative to traditional methods for closing "blown-out" aortic stumps in patients with Behçet's disease.
- This technique could improve outcomes and reduce recurrence rates in complex aortic stump management.
Abstract:
Successful aortic stump closure in a patient with Behçet's disease was accomplished with a permanent titanium clamp. In May 1990, a saccular infrarenal abdominal aortic aneurysm was detected in this patient, and prosthetic graft replacement was carried out. One year later, this graft was removed because of perigraft fluid collection; the aortic stump was sutured closed, and a right axillobifemoral bypass was done. In November 1994, the patient was admitted to the hospital because of an aortoenteric fistula. An emergency operation was performed, and the aortic stump was managed successfully with a permanent clamp. In patients with Behçet's disease, use of a permanent clamp may offer an alternative to traditional methods for closing blown-out aortic stumps.