Endovascular Approach To Azygos Vein Aneurysms - An Underutilized Approach?
Navid Ajabshir, MD, Huy Hoang, MD, Fernando Safdie, MD, Roy Williams, MD, Michael Ayad, MD.
Mount Sinai Medical Center of Florida, Miami Beach, FL, USA.
DEMOGRAPHICS: Azygos vein aneurysm (AZA) is an extremely rare finding with just under seventy cases ever reported. Intervention is warranted if the patient is symptomatic or to prevent adverse sequelae such as rupture or thromboembolism. If not managed conservatively, treatment has focused on resection via thoracoscopy or thoracotomy; a trend that has remained unchanged despite advances in endovascular techniques
HISTORY: We performed a literature review of reported AZA cases in the English literature over the past 10 years and summarized their results. We reviewed the case of a 67 yo female with a large, symptomatic AZA discovered after complaints of dysphagia.
PLAN: Over the past decade, the majority of patients have undergone surgical resection or conservative management, with 11% of reported cases utilizing an endovascular approach. The case reviewed was that of a patient managed with the relatively novel use of an endovascular covered stent, which proved to be a safe and effective approach and experienced complete resolution of her symptoms.
DISCUSSION: We reviewed a case of successful EVAR for symptomatic AZA with durable symptom free repair up to 4 months postoperatively. An endovascular approach should be considered with greater frequency for future management of this entity.
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