Reference no: EM133579980

Question

This is an 87-year-old male who presented to the ER with back pain. He was diagnosed with a large AAA that was asymptomatic in incidental finding. He was transferred to ABC Hospital for treatment. CT scan revealed a neck that was less than 15 mm, but greater than 1 cm with approximately a 50-degree angulation of the neck. Because of the patient's age, it was felt that endovascular repair would be the best situation for this patient. After informed consent was obtained from the patient's family, they agreed and wished to proceed. In the operating room, transverse groin incisions were made in the common femoral and profunda femoral. Superficial femoral arteries were dissected off. Control was obtained. Subsequently on the right, an entry needle was used to access the femoral artery. A guidewire was introduced and a 5- French sheath introduced. Subsequently, a Percor catheter was introduced into the aorta and an aortogram was performed. This revealed patent bilateral renal arteries. Mesenteric artery was patent. The neck of the aneurysm was visible approximately a centimeter and a half below the left renal artery. The large aneurysmal sac was visible as well as bilateral iliac arteries, which were patent. Subsequently, an Amplatz wire was inserted and the 5-French sheath was exchanged.