Emergency Endovascular Repair for a Ruptured Abdominal Aortic Aneurysm Patient
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We report a case of successful endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (rAAA) with a custom-made stent-graft placement. A 71-year-old man was admitted to his neighborhood hospital due to a loss of consciousness, where he was diagnosed as having recurrent brain infarction and given anti-coagulant agents. On the next day, his blood pressure dropped and the abdomen distended. Abdominal CT revealed an rAAA. Because the prothrombin time was 3.63 INR (International Normalized Ratio), it was judged to be very difficult to perform graft replacement of the aorta. Then, the patient was transferred to our hospital for application of EVAR. On the arrival, the patient's blood pressure was 60mmHg, and the hemoglobin level was 7.2g/dl. He was immediately moved to OR and was intubated. A stent-graft was made by a surgeon intraoperatively. Angiogram revealed a free rupture of AAA into the abdominal cavity (Fitzgerald type IV). After aorto-monoiliac stent-graft placement and lt. common iliac artery coil embolization, his blood pressure was stabilized. Then, F-F crossover bypass was added. Operation time was 121 minutes and the amount of blood loss was 60ml. Postoperative course was uneventful. The patient was discharged on the 12th postoperative day. With proper indication, EVAR may improve the current high perioperative mortality for rAAA.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
- Emergency Endovascular Repair for a Ruptured Abdominal Aortic Aneurysm Patient
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