Implications
References
Implications
IMPLICATIONS FOR ENDOVASCULAR THERAPY
In other words , the AAA anatomical parameters have a direct influence on the surgical plan . The short aneurysm neck , as in this case , would have posed a challenge for stent deployment . The presence of multiple branches would have increased the risk of EVAR failure due to retrograde filling of the aneurysm sac from these branches .
This juxtarenal AAA would have required a fenestrated EVAR stent which can extend the stent to the suprarenal aorta without compromising the renal blood flow ( Jones and Waduud , 2019 ) and the surgeons would have recommended close follow up afterward to detect any sign of treatment failure .
Through our engagement in cadaveric dissection , we were given the opportunity to transform a coincidental finding into a unique teaching opportunity . AAA is a life-threatening pathology , and its successful diagnosis , and management rely heavily on understanding its natural course and key anatomical parameters . We hope this article serves as a reminder of the valuable learning opportunities of post-mortem autopsy ; even today it is still a primary driver behind medical training and healthcare advancement .
England A , Mc Williams R . Endovascular aortic aneurysm repair ( EVAR ). The Ulster medical journal . Jan 2013 ; 82 ( 1 ): 3-10 .
Dansey KD , Varkevisser RRB , Swerdlow NJ , et al . Epidemiology of endovascular and open repair for abdominal aortic aneurysms in the United States from 2004 to 2015 and implications for screening . Journal of vascular surgery . Aug 2021 ; 74 ( 2 ): 414- 424 .
Detton AJ . Grant ' s Dissector . 15 , revised ed : Wolters Kluwer ; 2016 .
Chaikof EL , Fillinger MF , Matsumura JS , et al . Identifying and Grading Factors That Modify the Outcome of Endovascular Aortic Aneurysm Repair . Journal of Vascular Surgery , vol . 35 , no . 5 , 2002 , pp . 1061 – 1066 .
David M , Pelberg J , Kuntz C . Grey Turner ’ s sign . QJM : An International Journal of Medicine . 2012 ; 106 ( 5 ): 481-482 .
Jones AD , Waduud MA . Meta-analysis of fenestrated endovascular aneurysm repair versus open surgical repair of juxtarenal abdominal aortic aneurysms over the last 10 years . Oct 2019 ; 3 ( 5 ): 572-584 .
References
Lundberg GD . Low-tech autopsies in the era of high-tech medicine : continued value for quality assurance and patient safety . Jama . Oct 14 1998 ; 280 ( 14 ): 1273-1274 .
Weintraub NL . Understanding abdominal aortic aneurysm . The New England journal of medicine . Sep 10 2009 ; 361 ( 11 ): 1114-1116 .
USPSTF UPSTF . Final Recommendation Statement - Abdominal Aortic Aneurysm : Screening . December 2019 ; https :// www . uspreventiveservicestaskforce . org / uspstf / recommendation / abdominal-aorticaneurysm-screening .
Schanzer A , Messina L . Two decades of endovascular abdominal aortic aneurysm repair : enormous progress with serious lessons learned . Journal of the American Heart Association . Jun 2012 ; 1 ( 3 ): e000075 .