Page 5 - Virtual Vascular Vol 12
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Juxta-renal AAA
Open repair vs endovascular repair of Abdominal Aortic Aneurysms
A 85 year old male was diagnosed with an abdominal aortic aneurysm as part of
routine screening. When endovascular repair was initially introduced, it was reserved for
patient with suitable anatomy and poorer open surgical risk patients
Follow up surveillance aortic duplex revealed enlarging aneurysm up to 5 cm.
Subsequently CT aortogram was done to identify aortic anatomy and to facilitate
operative planning
Open repair Endovascular repair
Fits almost any anatomy Anatomical considerations
Celiac artery Large abdominal incision Small bilateral groin wounds
Superior mesenteric
artery Requires general anaesthesia Can be performed under MAC
(Monitored Anaesthesia Care)
Right renal artery
Blood loss Minimal blood loss
Low lying left renal Long post operative recovery Shorter post operative recovery
artery
Higher morbidity rates Lower morbidity
No long term surveillance Long term surveillance
Considered more durable Uncertain long term durability
Advances in stent graft technology has recently allowed us to treat
abdominal aneurysms which was previous considered unfavourable
for endovascular repair.
These include, fenestrated grafts and custom made devices.
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