Endovascular treatment of a noninfected anastomotic juxtarenal aortic aneurysm

An 82-year-old man underwent an endovascular procedure with a commercially available endovascular grail for an anastomotic juxtarenal abdominal aortic aneurysm. The anastomotic aneurysm, which showed no sign of infection, dev eloped 4 years after implantation of an aortic end-to-end graft for an infr arenal aortic aneurysm. The aneurysm was diagnosed during routine ultrasonographic follow-up; there was no apparent infection of the graft. Aortography confirmed the diagnosi s and also revealed a small pseudoaneurysm at The level of the distal aorti c anastomosis. Endovascular surgery was performed in the operating room wit h the guidance of C-arm fluoroscopy and intravascular ultrasound. Two Vangu ard(TM) Straight Endovascular Aortic Graft Cuffs (26 x 50 mm and 24 x 50 mm l were implanted successfully excluding both the anastomotic juxtarenal aor tic aneurysm and the distal pseudoaneurysm. The renal arteries were preserv ed and no early or late endoleaks were observed. The patient was discharged 2 days after the procedure. Sixteen months later , he was alive and well, with no endovascular leakage, no enlargement of th e aortic aneurysms, and no sign of infection. In our opinion, this experience shows that commercially available endovascu lar grafts may be used successfully to treat anastomotic aortic aneurysms a nd pseudoaneurysms.