Abdominal Aortic Aneurysm Case Study

Abdominal Aortic Aneurysm Case Study By Lisa Erwert Patient History 70 year old male Smoker High blood pressure

CABG Cholecystectomy Inguinal Hernia Repair Abdominal Aortic Aneurysm (AAA) About AAAs What is AAA?

Are AAAs deadly? Why are AAAs known as the silent killer? Where are they located?

Whos at risk? www.vascularsociety.org.uk Anatomy of Abdominal Cavity www.vascularsociety.org.uk Anatomy on CT

Recent History 10/28/05 8/28/06 Ultrasound CT of abdomen and pelvis 11/16/06

Endovascular Stent Graft placement 12/15/06 Follow-up CT of abdomen/pelvis Incidental Finding on Ultrasound AAA measuring 5.8 x 5.8 cm Proximal aorta - 2.4 x

2.3 cm Mid-abdominal - 2.3 x 2.4 cm R & L common iliac arteries - 1.2 cm Confirmation CT 8/28/06 Abdomen/Pelvis CT

Non-contrast 5mm axial images 100 cc of Ultravist 2 mm axial images in arterial CT Findings Cysts

in left kidney Additional Findings Normal L renal arteries & R renal veins

AAA measuring 6.7 x 6.7cm L common iliac measuring 2.6 x 2.7 cm R common iliac measuring 2.0 x 2.4 cm

CTs of AAA CT Angiograms (CTAs) Endovascular Stent Graft (Endograft) Procedure 11/16/06 Prep Incision

Placement of vascular sheath and pigtail Performed aortogram Stent Graft Components Constructed

of ePTFE Nitinol Support structure Pencil size in diameter Internally relines aorta Inserted by catheter 80-90% success rate Quicker recovery rate www.angioplasty-vir.com Endograft Procedure cont. Right

sheath exchange Deployment of stent graft Left sheath exchange Deployment of Contralateral stent graft Angioplasty Removal of catheters and wires Post-deployment of graft

Successful placement of graft Visible endoleak Follow-up CT

12/15/06 Abdomen 5mm axial / non-contrast 100cc 2mm / Pelvis

Ultravist delayed images CT Unchanged AAA Unchanged common

iliac arteris No evidence of endoleak Post CTAs Patient Prognosis Constant Observation

Possible further operations in future References Abdominal Aortic Aneurysm. Retrieved January 4, 2007, http://www.med.umich.edu/.

Endovascular Stent Graft for Abdominal Aortic Aneurysms. Retrieved January 22, 2007, from http://www.vascularweb.org /Endovascular_Stent_Graft.html Mosquera, Damien BSc MB ChB FRCS FRACS MD; 2002 D Mosquera Ltd, www.vascular.co.nz.

Netter, Frank H., Hansen, John T. (2001). Atlas of Human Anatomy. Nowygrod R, Egorova N, Greco G et al. Trends, complications, and mortality in peripheral vascular surgery. J Vasc Surg 2006; 43: 205-216.