Abstract
The mortality of ruptured abdominal aortic aneurysm (rAAA) remains high. Endovascular therapy with a stent-graft (EVAR) is minimally invasive and is used in rAAA. We treated a 74-year-old woman with rAAA by emergency stent grafting. Upon arrival, her blood pressure was only 55/32 mmHg and her heart rate was 104/min. Enhanced computed tomography (CT) revealed rAAA. The proximal neck was 14 mm in length and EVAR appeared feasible. We operated 52 minutes after her arrival, and repaired the rAAA by EVAR. After stent grafting, her hemodynamic status stabilized. The next day after surgery the abdominal cavity was punctured and 1400ml blood was removed. Her postoperative recovery was uneventful, there was no endoleak on postoperative enhanced CT and she was discharged 14 days after surgery. To perform EVAR in emergency situations, several preparations are required. However, emergency EVAR for rAAA may be selected for more rAAA patients in Japan in the near future.
