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Rupture of a Juxtarenal Abdominal Aortic Aneurysm after Segmental Artery Embolization before Fenestrated Endovascular Aortic Repair: A Word of Caution
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Aim: To highlight the impact of wire and catheter manipulation on aortic wall integrity in minimally invasive segmental artery coil embolization (MISACE) before fenestrated endovascular aortic repair (FEVAR).
Case: An 80-year-old male with a juxtarenal abdominal aortic aneurysm opted for FEVAR due to comorbidities. MISACE was done to prevent spinal cord ischemia (SCI) and type II endoleak before deploying a custom-made fenestrated endograft. Tragically, the patient succumbed to rupture three days post-MISACE.
Conclusion: Although MISACE offers proven and unproven protection against SCI and type II endoleaks respectively, the risks associated with wire and catheter manipulation during the procedure on the integrity of aortic walls remain understudied. Further studies are needed to highlight the impact of such manipulation in complex aortic aneurysms.
Hellenic Society of Vascular and Endovascular Surgery
Title: Rupture of a Juxtarenal Abdominal Aortic Aneurysm after Segmental Artery Embolization before Fenestrated Endovascular Aortic Repair: A Word of Caution
Description:
Aim: To highlight the impact of wire and catheter manipulation on aortic wall integrity in minimally invasive segmental artery coil embolization (MISACE) before fenestrated endovascular aortic repair (FEVAR).
Case: An 80-year-old male with a juxtarenal abdominal aortic aneurysm opted for FEVAR due to comorbidities.
MISACE was done to prevent spinal cord ischemia (SCI) and type II endoleak before deploying a custom-made fenestrated endograft.
Tragically, the patient succumbed to rupture three days post-MISACE.
Conclusion: Although MISACE offers proven and unproven protection against SCI and type II endoleaks respectively, the risks associated with wire and catheter manipulation during the procedure on the integrity of aortic walls remain understudied.
Further studies are needed to highlight the impact of such manipulation in complex aortic aneurysms.
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