Images in Clinical Medicine

Kim Eagle, M.D., Editor

Transfemoral Repair of Abdominal Aortic Aneurysm

Michael L. Marin, M.D., and Frank J. Veith, M.D.

N Engl J Med 1994; 331:1751December 29, 1994

• Slide

Article

Figure 1 Transfemoral Repair of Abdominal Aortic Aneurysm.

A Dacron prosthetic graft was sutured to a balloon-expandable metallic stent and inserted under local anesthesia through a right femoral-artery cutdown in a 70-year-old woman with an enlarging, tender 5.6-cm abdominal aortic aneurysm. Surgical repair was deemed too risky because the patient required oxygen for chronic pulmonary disease and had coronary artery disease. Aortography (Panel A) revealed the aneurysm (arrow) and a tortuous aorta, and computed tomography (CT) (Panel B) identified the aneurysm (arrow) and minimal mural thrombus (asterisk). The aortic reconstruction is illustrated in Panel C. The stent-graft device was packaged in a Teflon catheter and inserted retrogradely over a wire from the right femoral artery into the aorta along the course indicated by the large arrow. Balloon-expandable stents attached the Dacron graft to the neck of the aneurysm proximally and distally. The aneurysmal sac around the stent-graft thrombosed. A follow-up CT scan (Panel D) after placement of the stent-graft device showed a decrease in the size of the aneurysm, with thrombus surrounding the patent stent-graft (arrow). The patient has had no complications in the 14 months since the procedure, and follow-up CT scans show persistent exclusion of the aneurysm and arterial flow limited to the lumen of the graft.

Kim Eagle, M.D.

Michael L. Marin, M.D.
Frank J. Veith, M.D.
Montefiore Medical Center, New York, NY 10467

Citing Articles (3)

Citing Articles

1. 1

   Rina Maria Pereira Porta, Renato S??rgio Poggetti, Osvaldo Pereira, Cristina Chammas, Belchor Fontes, Ayrton Fratezi, Dario Birolini. (2006) An Experimental Model for the Treatment of Lethal Bleeding Injury to the Juxtahepatic Vena Cava With Stent Graft. The Journal of Trauma: Injury, Infection, and Critical Care 60:6, 1211-1220
   CrossRef

2. 2

   Michael L. Marin, Larry H. Hollier, Sharif H. Ellozy, David Spielvogel, Harold Mitty, Randall Griepp, Robert A. Lookstein, Alfio Carroccio, Nicholas J. Morrissey, Victoria J. Teodorescu, Tikva S. Jacobs, Michael E. Minor, Claudie M. Sheahan, Kristina Chae, Juliana Oak, Andrew Cha. (2003) Endovascular Stent Graft Repair of Abdominal and Thoracic Aortic Aneurysms. Transactions of the ... Meeting of the American Surgical Association 121, 279-288
   CrossRef

3. 3

   Jacob Cynamon, Michael L. Marin, Frank J. Veith, Curtis W. Bakal, James E. Silberzweig, Alla Rozenblit, Samuel I. Wahl. (1995) Endovascular Repair of an Internal Iliac Artery Aneurysm with Use of a Stented Graft and Embolization Coils. Journal of Vascular and Interventional Radiology 6:4, 509-512
   CrossRef