Endovascular treatment of non infected anastomotic abdominal aortic pseudoaneurysms after aortic reconstruction

The aim of this paper was to evaluate the effectiveness of endovascular repair of anastomotic abdominal aortic pseudoaneurysms occurring after previous open aortic prosthetic reconstruction for abdominal aortic aneurysms or aortoiliac obstructive disease. Between January 2005 and December 2006 we identified three patients with anastomotic abdominal aortic pseudoaneurysms following aortic open repair the average time interval between the primary surgery and endovascular treatment was 8 years (range 6-11 years). No patient had symptoms or positive parameters for infection. One patient was treated with bifurcated stent graft followed by visceral vessels reimplantation by means of sequential Dacron bypass, one with tube stent graft and one with aortouniliacal stent graft followed by a femoro-femoral by-pass. Endovascular stent graft were successfully inserted in all patients. There were no major complications, surgical conversions or deaths. At follow-up (mean 14 months) there were no deaths, endoleaks or graft migration observed. This case illustrates the feasibility of endografting for repair of anastomotic abdominal aortic pseudoaneurysms, so we conclude that endovascular treatment represent a viable alternative to open surgical repair and greatly reduces the risk of morbidity and mortality.