Treatment options for aneurysms in high-risk patients

A non-resective therapy for abdominal aortic aneurysm: intravascular thrombosis by dropping inflatable balloons

A case of subrenal abdominal aortic aneurysm treated by unipolar exclusion and axillobifemoral bypass is reported. The exclusion was performed by inserting inflatable balloons through a femoral access and obstructing the iliac arteries. This technique may be useful in poor-risk patients with a symptom-free aneurysm.

Results of an exclusion technique for treatment of abdominal aortic aneurysm

An exclusion technique for the treatment of abdominal aortic aneurysm was used in six patients considered to be at high operative risk mainly because of chronic pulmonary disease. There were no deaths or immediate major complications. Thrombosis of the aneurysm was achieved in four of the six patients. However, in three cases, repeated percutaneous embolization was required to produce thrombosis. One patient developed a secondary rupture of a persisting infrarenal sac resulting from a patent inferior mesenteric artery. This patient was successfully managed by ligature of the infrarenal portion of the abdominal aorta through a median laparotomy. This study emphasizes the limits and the risks of the exclusion technique.