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. 2025 Aug 8;104(32):e43941.
doi: 10.1097/MD.0000000000043941.

EVAR solution for acute thrombosis of abdominal aortic aneurysm: A case report and literature review

Xiping Xu  1 , Shumeng Yang, Jihua Shi, Tao Qin, Yubin Li
Affiliations

EVAR solution for acute thrombosis of abdominal aortic aneurysm: A case report and literature review

Xiping Xu et al. Medicine (Baltimore). .

Abstract

Rationale: Acute thrombosis of an abdominal aortic aneurysm (ATAAA) is a rare but catastrophic complication of abdominal aortic aneurysm. For inherently high-risk ATAAA, a more invasive open surgical approach is associated with increased mortality.

Patient concerns: A 68-year-old male presented with sudden-onset severe back and lower limb pain persisting for over 9 hours. Physical examination revealed a pulsatile abdominal mass and bilateral lower limb ischemia.

Diagnoses: Computed tomography angiography revealed a 4.5 cm infrarenal abdominal aortic aneurysm with acute thrombosis extending into both common iliac arteries, confirming the diagnosis of ATAAA.

Interventions: The proximal neck anatomy of the aneurysm was suitable for endovascular aneurysm repair (EVAR); accordingly, balloon thrombectomy followed by EVAR was performed.

Outcomes: Complete revascularization was achieved. The patient was discharged on postoperative day 4 and remained asymptomatic at the 2-year follow-up.

Lessons: Only 5 cases of ATAAA treated with an endovascular approach have been reported. Although further validation is needed, EVAR shows promise as a safe and effective treatment for selected cases, potentially reducing the high mortality rate associated with this condition.

Keywords: abdominal aortic aneurysm; acute thrombosis; balloon thrombectomy; endovascular aneurysm repair.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Preoperative CTA showed acute thrombosis of a 4.54 cm infrarenal AAA and both common iliac arteries (white arrows). The proximal neck of the AAA was patent and suitable for EVAR. AAA = abdominal aortic aneurysm, CTA = computed tomography angiography, EVAR = endovascular aneurysm repair.
Figure 2.
Figure 2.
Aortography before (A) and after (B) EVAR. The stent-graft was well-positioned without apparent stenosis or endoleaks. EVAR = endovascular aneurysm repair.
See this image and copyright information in PMC

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