Objective: To explore the indications, methods, manipulations, and problems of endovascular exclusion of abdominal aortic aneurysm (AAA).
Method: Under general anesthesia and dynamic supervision of DSA, an endovascular exclusion with a stent-graft complex of 11.0 cm x 2.6 cm was successfully performed on a 70-year-old man contraindicated for major open surgery with AAA of 10.0 cm x 6.0 cm and an AAA neck of 2.5 cm x 1.6 cm.
Result: The patient was up and about on the first postoperative day. Duplex scan (by the end of the first postoperative week) and CT (on the postoperative 20th day) revealed a completely excluded AAA by the stent-graft that was patent and had an inner diameter of 2.2-2.4 cm, without migration and torsion. The primary AAA sac was full of thrombi and no patent lumbar and inferior mesenteric arteries were observed. The external diameter of AAA was unchanged, renal and iliac arteries were all patent, but a micro-crevice between the proximal end of the stent-graft and the anterior wall of the AAA neck was revealed. Six months postoperative follow-up showed that the patient's abdominal pulsatile mass and the left lower extremity's claudication disappeared.
Conclusion: Endovascular exclusion of AAA is of great practical value.