Abstract:

Endovascular aneurysm repair (EVAR) is the first line approach in abdominal aortic aneurysm (AAA) repair. Open surgical repair of AAA is associated with high perioperative mortality and morbidity. A sufficient infrarenal aortic neck is one of the key points for successful outcome after EVAR. We presented in this case report a 75 year- old, male patient with AAA which maximal diameter is 60 mm. The aneurysm had a large neck that presents a hostile neck anatomy. He was unfit for conventional surgery because of comorbidities as chronic obstructive pulmonary disease, newly diagnosed lung cancer and coronary artery disease. He applied to the emergency service with severe and acutely onset back pain and he was admitted to our cardiovascular surgery clinic. Because of acute onset of the back pain, his serious comorbidities and we planned to use of thoracic and abdominal aortic endovascular stent-graft systems indwelling each other which is known as Funnel technique. Despite progress in endovascular therapy, large infrarenal necks remain a challenge for endovascular interventionists. It seems feasible to use combined thoracic and abdominal stent graft as an alternative treatment modality when the patient is not suitable for standard EVAR and open surgery.

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