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A unique technique for intentional occlusion of an abdominal aortic aneurysm
Since the first report of an endovascular repair of an abdominal aortic aneurysm (AAA) in 1991, repair of AAAs has undergone a transformation due to lower reported 30-day mortality rates.1 Traditional open surgery involving aneurysmectomy and reconstruction has evolved to endoluminal placement of a stent graft to exclude the aneurysm. Open surgery has a reported operative mortality of w3% to 5% in the relatively healthy patient.2 The risk can be much higher in sicker patients with multiple comorbidities.3 An alternative approach to open aneurysmectomy with reconstruction in a high-risk cohort is ligation treatment of aneurysms and an extra-anatomic bypass, which was originally described in 1965.4 Having fallen out of favor in the minimally invasive era, there may be a role for an endovascular variant of this form of intervention. We report the case of a high-risk patient with a prior axillary-bifemoral bypass and an enlarging infrarenal AAA who was treated with intentional endovascular occlusion of the AAA.
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