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Stents to the Rescue: Battling a Ruptured Abdominal Aneurysm

Jie Wang, MD
Ping Hu, MD
Ming Qi, MD
Xiao-Jing Ma, PhD
Keywords

© 2025 HMP Global. All Rights Reserved.
Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of the Journal of Invasive Cardiology or HMP Global, their employees, and affiliates. 

J INVASIVE CARDIOL 2025. doi:10.25270/jic/25.00034. Epub February 21, 2025.

A 72-year-old woman presented with acute onset of abdominal pain accompanied by nausea and vomiting for 10 hours. Computed tomography angiography (CTA) revealed a ruptured abdominal aortic aneurysm (AAA) measuring 80 × 78 × 82 mm with extensive intraperitoneal hemorrhage (Figure A-C, arrows). Because of the emergent nature of her condition, the patient underwent emergency endovascular repair with Endurant 25-16-166 and 16-20-124 stent grafts (Medtronic) placed in the abdominal aorta and bilateral iliac arteries (Figure D, Video). The postoperative course was uneventful, and the patient was discharged to a rehabilitation center after 3 days.

AAA has a prevalence of approximately 4.8%.1 Rupture of AAA is associated with high mortality, necessitating surgical intervention when the aneurysm diameter exceeds 5.5 cm. Endovascular aneurysm repair (EVAR) has emerged as the predominant modality for managing AAA. CTA plays a pivotal role in the diagnosis and management of AAA by providing detailed visualization of the aneurysm's anatomy, which enables precise preoperative planning, postoperative follow-up, and detection of complications such as endoleaks, thrombus formation, and graft infections. In cases of suspected rupture, CTA is indispensable for identifying the extent of the rupture, assessing surrounding tissue involvement, and guiding emergency interventions. Furthermore, CTA facilitates the detection of subtle anatomical variations and complications that may influence treatment decisions, thereby enhancing patient outcomes and reducing morbidity and mortality.

Figure
Figure. (A-C) Emergency endovascular repair of a ruptured AAA in a 72-year-old woman. Computed tomography angiography images showing a ruptured AAA, measuring 80 × 78 × 82 mm, with extensive intraperitoneal hemorrhage (arrows). (D) The images highlight the extent of the rupture and the associated hemorrhage. Image of the endovascular aneurysm repair confirms successful exclusion of the AAA and correct positioning of the stent grafts placed in the abdominal aorta and bilateral iliac arteries. AAA = abdominal aortic aneurysm.

 

Affiliations and Disclosures

Jie Wang, MD1; Ping Hu, MD2; Ming Qi, MD3; Xiao-Jing Ma, PhD2

From the 1Department of Radiology, Wuhan Asia Heart Hospital, Affiliated Wuhan University of Science and Technology, Wuhan, China; 2Department of Echocardiography, Wuhan Asia Heart Hospital, Wuhan, China; 3Department of Cardiovascular Surgery, Wuhan Asia Heart Hospital, Wuhan, China. 

DrWang, Dr Hu, and Dr Qi served as co-first authors.

Disclosures: The authors report no financial relationships or conflicts of interest regarding the content herein.

Funding: This work was funded by the Wuhan Clinical Medical Research Center for Cardiovascular Imaging and the Open Fund of Imaging Center (Project No. CMRC202302).

Consent statement: This report has obtained the patient's informed consent for the publication of their anonymized clinical data.

Data availability statement: The data that support the findings of this study are available from the corresponding author.

Address for correspondence: Xiao-Jing Ma, PhD, Department of Echocardiography, Wuhan Asia Heart Hospital, No 753 Jinghan Road, Hankou District, Wuhan 430022, China. Email: ma312312ma@163.com

 

Reference:

  1. Li X, Zhao G, Zhang J, Duan Z, Xin S. Prevalence and trends of the abdominal aortic aneurysms epidemic in general population--a meta-analysis. PLoS One. 2013;8(12):e81260. doi:10.1371/journal.pone.0081260

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