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

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.