Unusual treatment of abdominal aortic aneurysm: Aortic stenting with covered stent

Abstract

Introduction: It is now becoming increasingly difficult to accept that some patients are not suitable for surgery due to high surgical risk. The continuous technological progress, in the endovascular field in particular, are urging surgeons to put the limit even more forth.

Presentation of case: We are going to describe an endovascular option used to treat an infrarenal aortic aneurysm where the diameter of the iliac vessels couldn't allow the use of any device available on the market. Three covered AdvantaV12 stents were placed in series in the aorta to build the endoprosthesis body and two Bard Fluency 8mm×60mm were then placed in a "kissing way" into the common iliac arteries like legs.

Discussion: Continuous technological progress, particularly in the endovascular field, is driving surgeons to push the limits even further. Nevertheless, some things still seem not to be possible, but in comparison to traditional surgery where all is well demonstrated and documented, the endovascular approach is still a young discipline and allows us to try to find new solutions.

Conclusion: We can therefore assert that in exceptional circumstances, an aortic endoprosthesis can be built inside the aortic lumen using covered stents.

Fig. 1

AngioCT scan showing a large infrarenal aneurysm with very small iliac arteries.

Fig. 2

Final intraoperative angiogram and 6-months AngioCT scan reconstruction.