Rapidly enlarging and asymptomatic abdominal aortic aneurysm in a male patient with chronic obstructive pulmonary disease: A case report of early experience of endovascular aortic aneurysm repair (EVAR).

ABSTRACT

Objective: to report a case of an incidental large asymptomatic AAA in an ex-smoker with severe COPD successfully treated by EVAR and to delineate the results and complications of EVAR performed in operative theater of Siriraj Hospital. Methods: A retrospective review of selected high-risk patients with asymptomatic AAA treated by EVAR in operative theater of our hospital from August 2003 to December 2005 was performed. Results: All nine cases (100%), including reported case (100%), were successfully treated by EVAR. Merely one of 30-day peri-operative death (11.1%), of post-operative cardiopulmonary arrest (11.1%), of early AAA rupture (11.1%), of early graft limb occlusion (11.1%), of late graft limb occlusion (11.1%), and of early type II endoleak (11.1%) took place in this study. Neither late AAA rupture, AAA sac enlargement, nor graft migration happened. Conclusion: EVAR was achieved as a minimal invasive treatment of an incidental large asymptomatic AAA in an ex-smoker with severe COPD. Although EVAR provides an excellent alternative of AAA in high-risk patients, its high peri-operative mortality rate around 10 % should be taken into account.