ABSTRACT
A ruptured abdominal aortic aneurysm is an emergency anywhere in the world. Physician
expertise and clinical status of the patient drive the treatment modalities in the
majority of cases. Independent of treatment choice, the goal of therapy is to stabilize
the patient as quickly as possible in a manner that establishes maximum survival and
minimum morbidity and provides a long-lasting, durable result. Endovascular aortic
repair has become an acceptable alternative to open surgical repair in a subset of
patients presenting with ruptured aortoiliac aneurysms. Patient selection, physician
preference, institutional experience, and availability of appropriate equipment make
up a majority of factors influencing treatment choices. Once the decision has been
made to treat the patient via endovascular techniques, then experience, planning,
and the ability to improvise solutions “on the fly” become vital components to the
success of the procedure. Two separate cases, requiring intraprocedural improvisation,
are presented followed by a review of the literature.
KEYWORDS
Ruptured aneurysm - emergent stent graft - EVAR
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Kenneth J KolbeckM.D. Ph.D.
Assistant Professor, Dotter Interventional Institute, Oregon Health and Science University
3181 SW Sam Jackson Park Road–L605, Portland, OR 97239
eMail: kolbeckk@ohsu.edu