Ruptured AAA after EVAR Thrombosis
Jesse Victory, D.O., Ali Syed Rizi, D.O., Anil Hingorani, MD, Enrico Ascher, MD.
Total Vascular Care, Brooklyn, NY, USA.
Objective:
To determine the importance of surveillance in patients with a completely thrombosed endovascular aortic aneurysm repair (EVAR).
Presentation:
We present the case of a 71-year-old male who presented with acute limb ischemia due to a thrombosed infra-renal aortic endograft. An axillary to bi-femoral artery bypass was required to restore blood flow to the lower extremities. Post operatively, the patient was lost to follow up, but returned two years later with a ruptured abdominal aortic aneurysm (AAA). The patient was taken emergently to the operating room for repair, where it was determined that a type 1A endoleak was present. Due to the endoleak, the thrombosed AAA sac had increased in size resulting in the rupture.
Conclusion:
We propose that all patients after EVAR, including those with a thrombosed aortic endograft, continue to undergo regular graft surveillance. This case report highlights the importance of continued surveillance of the aortic sac, even after total thrombosis of the EVAR.
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