Clamp before you cut: Proximal control of ruptured abdominal aortic aneurysms using endovascular balloon occlusion--Case reports

Vasc Endovascular Surg. Mar-Apr 2006;40(2):149-55. doi: 10.1177/153857440604000210.

Abstract

While the mortality rate for elective abdominal aortic aneurysm (AAA) repair has declined over the last several decades, the rate for ruptured abdominal aortic aneurysm (RAAA) has unfortunately remained disturbingly high. Undiagnosed aneurysms may present with little warning until abdominal pain, syncope, and hypotension signify rupture. Fifty percent of patients with ruptured aneurysms die before reaching a medical facility, and their survival is highly dependent on hemodynamic stability at presentation. The degree of rupture containment and comorbid status of the patient determine hemodynamic stability. Endovascular stent grafting has significantly improved perioperative morbidity and mortality rates for elective AAA repair, and some of the same endovascular techniques can be used to obtain proximal control in patients presenting with RAAA. We describe 3 consecutive cases of RAAA where proximal control was obtained using a percutaneously placed, transfemoral aortic occlusion balloon before induction of anesthesia.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Algorithms
  • Angioplasty, Balloon* / instrumentation
  • Angioplasty, Balloon* / methods
  • Aortic Aneurysm, Abdominal / surgery
  • Aortic Aneurysm, Abdominal / therapy*
  • Aortic Rupture / surgery
  • Aortic Rupture / therapy*
  • Hemostatic Techniques* / instrumentation
  • Humans
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Preoperative Care* / instrumentation
  • Preoperative Care* / methods
  • Rupture, Spontaneous / surgery
  • Rupture, Spontaneous / therapy
  • Stents
  • Treatment Outcome
  • Vascular Surgical Procedures