Patient-individualized treatment concept in a case of a juxtarenal AAA repair with limited transfemoral access using custom-made fenestrated aortic endografts

Endovascular techniques have become the preferred method for treating complex aortic aneurysms, but some cases require individualized strategies beyond manufacturer specifications. We report a 62-year-old male with a 64 mm juxtarenal abdominal aortic aneurysm, right above-knee amputation, and depend...

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Main Authors: Bernhard Hruschka, Alexander Gombert, Panagiotis Doukas, Christian Uhl, Moustafa Elfeky
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Annals of Vascular Surgery - Brief Reports and Innovations
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772687824000928
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author Bernhard Hruschka
Alexander Gombert
Panagiotis Doukas
Christian Uhl
Moustafa Elfeky
author_facet Bernhard Hruschka
Alexander Gombert
Panagiotis Doukas
Christian Uhl
Moustafa Elfeky
author_sort Bernhard Hruschka
collection DOAJ
description Endovascular techniques have become the preferred method for treating complex aortic aneurysms, but some cases require individualized strategies beyond manufacturer specifications. We report a 62-year-old male with a 64 mm juxtarenal abdominal aortic aneurysm, right above-knee amputation, and dependence on the right hypogastric artery. The patient's complex anatomy necessitated a custom solution including fEVAR. Access was gained through the left femoral and brachial arteries due to an occluded right external iliac artery. The right hypogastric artery was treated with covered stents via transbrachial access. This case highlights the potential for treating complex aortic aneurysms using patient-individualized endoprostheses and creative endovascular solutions outside standard instructions-for-use.
format Article
id doaj-art-692177f1e23348e2a3bd21f4dde1d8bf
institution DOAJ
issn 2772-6878
language English
publishDate 2024-12-01
publisher Elsevier
record_format Article
series Annals of Vascular Surgery - Brief Reports and Innovations
spelling doaj-art-692177f1e23348e2a3bd21f4dde1d8bf2025-08-20T02:50:19ZengElsevierAnnals of Vascular Surgery - Brief Reports and Innovations2772-68782024-12-014410034010.1016/j.avsurg.2024.100340Patient-individualized treatment concept in a case of a juxtarenal AAA repair with limited transfemoral access using custom-made fenestrated aortic endograftsBernhard Hruschka0Alexander Gombert1Panagiotis Doukas2Christian Uhl3Moustafa Elfeky4Corresponding author.; Department of Vascular Surgery, European Vascular Center Aachen Maastricht, RWTH, University Hospital Aachen, Pauwelsstrasse 30, Aachen 52074, GermanyDepartment of Vascular Surgery, European Vascular Center Aachen Maastricht, RWTH, University Hospital Aachen, Pauwelsstrasse 30, Aachen 52074, GermanyDepartment of Vascular Surgery, European Vascular Center Aachen Maastricht, RWTH, University Hospital Aachen, Pauwelsstrasse 30, Aachen 52074, GermanyDepartment of Vascular Surgery, European Vascular Center Aachen Maastricht, RWTH, University Hospital Aachen, Pauwelsstrasse 30, Aachen 52074, GermanyDepartment of Vascular Surgery, European Vascular Center Aachen Maastricht, RWTH, University Hospital Aachen, Pauwelsstrasse 30, Aachen 52074, GermanyEndovascular techniques have become the preferred method for treating complex aortic aneurysms, but some cases require individualized strategies beyond manufacturer specifications. We report a 62-year-old male with a 64 mm juxtarenal abdominal aortic aneurysm, right above-knee amputation, and dependence on the right hypogastric artery. The patient's complex anatomy necessitated a custom solution including fEVAR. Access was gained through the left femoral and brachial arteries due to an occluded right external iliac artery. The right hypogastric artery was treated with covered stents via transbrachial access. This case highlights the potential for treating complex aortic aneurysms using patient-individualized endoprostheses and creative endovascular solutions outside standard instructions-for-use.http://www.sciencedirect.com/science/article/pii/S2772687824000928Case reportComplex AAAAbdominal aortic aneurysmJuxta-renal aortic aneurysmShort custom-made devicefEVAR
spellingShingle Bernhard Hruschka
Alexander Gombert
Panagiotis Doukas
Christian Uhl
Moustafa Elfeky
Patient-individualized treatment concept in a case of a juxtarenal AAA repair with limited transfemoral access using custom-made fenestrated aortic endografts
Annals of Vascular Surgery - Brief Reports and Innovations
Case report
Complex AAA
Abdominal aortic aneurysm
Juxta-renal aortic aneurysm
Short custom-made device
fEVAR
title Patient-individualized treatment concept in a case of a juxtarenal AAA repair with limited transfemoral access using custom-made fenestrated aortic endografts
title_full Patient-individualized treatment concept in a case of a juxtarenal AAA repair with limited transfemoral access using custom-made fenestrated aortic endografts
title_fullStr Patient-individualized treatment concept in a case of a juxtarenal AAA repair with limited transfemoral access using custom-made fenestrated aortic endografts
title_full_unstemmed Patient-individualized treatment concept in a case of a juxtarenal AAA repair with limited transfemoral access using custom-made fenestrated aortic endografts
title_short Patient-individualized treatment concept in a case of a juxtarenal AAA repair with limited transfemoral access using custom-made fenestrated aortic endografts
title_sort patient individualized treatment concept in a case of a juxtarenal aaa repair with limited transfemoral access using custom made fenestrated aortic endografts
topic Case report
Complex AAA
Abdominal aortic aneurysm
Juxta-renal aortic aneurysm
Short custom-made device
fEVAR
url http://www.sciencedirect.com/science/article/pii/S2772687824000928
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