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Traumatic abdominal aortic pseudoaneurysm treated with balloon-expandable bifurcated endoprosthesis
L Bechara-Zamudio1, G Olivé, H Barone
1Department of Cardiovascular Surgery, Hospital Militar Central, Universidad de Buenos Aires, Argentina.
Journal of Vascular Surgery
|August 27, 1998
Summary
A patient with massive intra-abdominal hemorrhage due to an aortic pseudoaneurysm was successfully treated with a novel endovascular approach. This minimally invasive technique resolved the life-threatening condition, offering a viable alternative to open surgery.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Trauma Surgery
Background:
- A 22-year-old male presented with severe upper gastrointestinal bleeding and intra-abdominal hemorrhage.
- History of abdominal gunshot injury 9 months prior, resulting in aortic and intestinal perforations.
- Previous treatment involved primary aortic closure and intestinal resections.
Observation:
- An angiogram revealed a descending aortic pseudoaneurysm.
- Conventional open surgical repair was deemed high-risk due to extensive prior abdominal surgeries.
- The patient experienced recurrent bleeding and hemodynamic instability.
Findings:
- A custom balloon-expandable bifurcated endoprosthesis was successfully deployed.
- The endovascular repair was performed via a femoral artery approach.
- The abdominal aortic pseudoaneurysm was completely excluded, and hemorrhage resolved.
Implications:
- Endovascular repair of complex aortic pseudoaneurysms is feasible even after multiple abdominal surgeries.
- Minimally invasive techniques offer a life-saving alternative in complex trauma cases.
- This approach potentially reduces morbidity associated with re-operative open surgery for aortic injuries.