Endovascular Repair of Infrarenal Abdominal Aorta Penetrating Atherosclerotic Ulcers: Review of Our Experience

(a) Contrast-enhanced abdominal CT scan: infrarenal pseudoaneurysm, in addition to extensive aortic calcification. (Note the focal rupture in the left-anterior surface of the infrarenal aorta, which is related to the break in the calcified aortic wall. This area is protruding left-anteriorly to form the pseudoaneurysm). (b) Angiography: infrarenal pseudoaneurysm with very localized extravasation of contrast medium. (c) Follow-up abdominal CT scan 3 months after the intervention: intact stent-graft with no endoleak, migration, twisting or dilation of the diseased aortic segment.

(a) Contrast-enhanced abdominal CT scan: infrarenal pseudoaneurysm, in addition to extensive aortic calcification. (b) Angiography: aorta of normal caliber with no signs of aneurysm formation. Infrarenal pseudoaneurysm, containing fresh thrombus, with very localized extravasation of contrast medium. (c) Follow-up CT-angiography 3 months after the intervention: intact stent-graft with no endoleak or migration.

(a) Abdominal CT scan without I.V. contrast medium: extensive abdominal aorta calcification. Extensive amount of hemorrhagic fluid in the retroperitoneal space with intense displacement of the left kidney foreward, and obscurity of abdominal aortic wall, findings implying abdominal aorta rupture. (b) Contrast-enhanced abdominal CT scan: huge extravasation of contrast medium, confirming aortic rupture. (c) Abdominal CT scan immediately after endovascular repair: stent-graft patency without any evidence of endoleak. (d) Follow-up DSA 12 months after the intervention: stent-graft patency with no evidence of endoleak or migration.

(a) Contrast-enhanced abdominal CT scan: extensive calcification of common iliac arteries. Extensive extravasation of contrast medium. (b) CT-angiography: extensive atherosclerotic disease of abdominal aorta and common iliac arteries. Extensive extravasation of contrast medium at the level of the origin of the left common iliac artery, confirming rupture.