Translumbar extraperitoneal decompression for XXXX after endovascular treatment of a ruptured AAA.

@entity1 @entity1755 @entity8479 @entity615 @entity1756
PURPOSE: To report an unusual case of @entity8479 ( @entity8479 ) following endovascular repair of a @entity1755 ( @entity1755 ) that had been treated with a stent-graft 3 years prior. CASE REPORT: A 68-year-old @entity1 with a 3-year-old Vanguard bifurcated aortic stent-graft experienced @entity615 and collapse. @entity1756 documented by computed tomography was due to dislocation of the left graft limb. A Talent aortomonoiliac graft was deployed, followed by a femorofemoral bypass. No endoleak was evident. A few hours later, the @entity1 became oliguric and hemodynamically unstable. Increased intra-abdominal pressure (IAP) was recorded. Abdominal decompression was performed, removing 1500 mL of blood from the retroperitoneum through an 18-cm lumbotomy; the peritoneum was opened, and another 500 mL of blood was aspirated. The IAP fell immediately, followed by diuresis a few hours later. The @entity1 recovered and was discharged after 27 days. CONCLUSIONS: Some of the perioperative complications seen after conventional @entity1755 repair are also encountered after endovascular treatment. @entity8479 requires urgent decompression, and less invasive approaches, such as translumbar extraperitoneal decompression, may be a good alternative to a midline laparotomy.
