A Case of Juxtarenal Abdominal Aortic Aneurysm Treated with EVAR Using Viabahn with the Snorkel Technique

Abstract

A 93-year-old woman visited our hospital for the treatment of a juxtarenal abdominal aortic aneurysm (JAAA), which was 54 mm in diameter. The angle of the neck and axis of the JAAA was 100 degrees. Because of the patient’s age, it would be risky to perform open surgery; however, standard endovascular aneurysm repair (EVAR) might result in increased high risk for type Ia endoleak or obstruction of the renal artery. Thus, a wait-and-see approach was adopted. However, after half a year, the JAAA was already 59 mm in diameter. To reduce the risk of a ruptured aneurysm, we performed EVAR with the snorkel technique using a covered stent. Afterward, the patient achieved good progress without complications, such as renal dysfunction. After 2 years, the JAAA has shrunk to 36 mm in diameter. Therefore, EVAR with the snorkel technique is effective for the treatment of JAAA.