Induced thrombosis of inoperable abdominal aortic aneurysm

R. Berguer, J. Schneider, H. I. Wilner

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

On occasions it may be vital to produce controlled thrombosis of an abdominal aortic aneurysm when resection is not possible. A successful technique was evolved to achieve this in a 57-year-old man with malignant lymphoma. The tumor was found to infiltrate massively the retroperitoneum and the wall of a large abdominal aortic aneurysm. The large aneurysm was deemed to be technically unresectable at operation. An approach was devised to thrombose the aneurysm and to proceed safely with chemotherapy of the malignant lymphoma. An axillobifemoral bypass was made with the limbs anastomosed end to end to the common femoral arteries. The external iliac vessels were exteriorized through the abdominal wall. The aneurysmal sac outflow was occluded by balloon catheters introduced through the exteriorized iliac vessels. A right transaxillary catheter was inserted and placed at the level of the renal arteries to induce and to control the progress of thrombus formation in such a way as to ensure patency of the renal vessels. Thrombin was delivered into the sac via this transaxillary catheter. A high urinary output was maintained. Serial angiograms of the clotting process were obtained. Once the sac was thrombosed, the balloon catheters were removed and a final angiogram was obtained which demonstrated the obliteration of the aneurysmal sac and the patency of the renal vessels. The patient has been fully employed for 20 months.

Original languageEnglish (US)
Pages (from-to)425-429
Number of pages5
JournalSurgery
Volume84
Issue number3
StatePublished - Dec 1 1978

ASJC Scopus subject areas

  • Surgery

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