Riparazione endovascolare di pseudoaneurisma su protesi aortica. Caso clinico e considerazioni sulla grave patologia

Endovascular Repair of Aortic False Aneurysm - Case Report and Considerations about the Serious Pathological Condition. Aortic graft false aneurysm represents a rare, but serious disease, because of the absence of symptoms and of the dangerous complications: abdominal rupture and aortoenteric fistula. A clinical case is reported of a false aneurysm arising from the reimplantation of the inferior mesenteric artery and a polar renal artery on a end-to-end infrarenal aortic graft, inserted to repair an aneurysm. The case was treated by exclusion of the pseudoaneurysm by means of a stent graft, inserted through the femoral artery. Surgical reinterventions for graft false aneurysms are associated with high morbidity and mortality, due to the difficult dissection through scarred tissues and adhesions caused by the primary surgery, due to the problems connected with aortic clamping and with the frequent intimate adhesions between false aneurysm and duodenum, with consequent possible contamination of the graft. The positioning of a stent graft through the femoral artery under local anaesthesia, drastically reduces the invasiveness and the possible complications of the surgical repair. We think therefore that endovascular exclusion, when applicable, should represent the treatment of choice for arterial graft pseudoaneurysm.