CASE REPORTS   

Italian Journal of Vascular and Endovascular Surgery 2004 June;11(2):101-5

Copyright © 2004 EDIZIONI MINERVA MEDICA

lingua: Inglese

Aortic endoprosthesis explantation: left retroperitoneal approach

Sardella S. G. ¹, Berchiolli R. ¹, Napoli V. ², Vignali C. ², Del Corso A. ¹, Adami D. ¹, Di Mitri R. ¹, Ferrari M. ¹

¹ Unit of Vascular Surgery Azienda Ospedaliera Pisana, Pisa, Italy 2 Angiography and Vascular Interventional Section Division of Diagnostic and Interventional Radiology Department of Oncology, Transplantations and New Technologies University of Pisa Imaging Department, “Cisanello” Hospital, Pisa, Italy

The ­case of a ­patient sub­mit­ted to ­late, elec­tive, sur­gi­cal con­ver­sion 28 ­months ­after endo­lu­mi­nal ­repair for aor­tic aneu­rysm exclu­sion, is pre­sent­ed. On fol­low-up, the ­patient had under­gone per­cut­ane­ous embol­iza­tion due to 2 ­type II endo­leaks and 2 prox­i­mal extend­er ­cuffs had ­been posi­tioned to ­solve 2 ­type IV endo­leaks. In addi­tion, cau­dal migra­tion of the ­stent-­graft had ­been detect­ed, not asso­ciat­ed ­with a ­type I endo­leak. Despite sec­on­dary pro­ce­dures, the aneu­rys­mal sac suf­fered pro­gres­sive ­growth. The inev­i­ta­ble sur­gi­cal con­ver­sion was per­formed ­through a ­left ret­ro­per­i­to­neal lum­bar ­access, to sim­pli­fy the tech­ni­cal dif­fi­cul­ties asso­ciat­ed ­with per­i­ad­ven­ti­tial scler­o­sis. Using ­this ­approach, ­easy suprar­en­al clamp­ing was ­achieved. Postoperative glo­bal func­tion resump­tion of the ­patient was rap­id, ­despite the ­patient's res­pir­a­to­ry dys­func­tion, ­which had deter­mined the ­choice of endo­lu­mi­nal ­repair.