Acute rupture of an aortic false aneurysm treated with a stent-graft

Purpose: To report the use of an aortic endograft to treat a ruptured false aneurysm at the anastomosis of an aortofemoral bypass graft. Methods and Results: A 68-year-old man with a 30-year-old aorto-right femor al bypass and multiple comorbidities was admitted to the hospital complaini ng of acute abdominal pain. Imaging identified a 60-mm ruptured aortic fals e aneurysm with associated retroperitoneal hematoma, a 9-cm right femoral f alse aneurysm, and a calcified 23-mm left common iliac aneurysm. Two slight ly overlapping Vanguard straight stent-grafts were implanted in the aorta a nd left common iliac artery in an emergency procedure owing to the patient' s high surgical risk. The anastomotic false aneurysm and the bypass were ex cluded. A left-to-right femorofemoral bypass was performed to re-establish flow to the right femoral artery with ligation of the external iliac artery . The patient recovered uneventfully. He remained well with a successful re pair until his death of a myocardial infarction 6 months after the procedur e. Conclusions: Endovascular grafting can be used successfully for the urgent treatment of aortic false aneurysm rupture.