PubMed · 5931808
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W G Austen, R W DeSanctis. 1966. Dissecting aneurysm.. https://doi.org/10.1016/s0039-6109(16)37884-7
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Marfan's syndrome is an inherited disorder of the connective tissue. Cardiologic manifestations, especially aortic dilation, are important causes of morbidity and mortality in the clinical course of the disease in adults and teenagers. In children, the presence of aortic aneurysm and its dissection or rupture is rare, occurring in patients with genetic mutation of the fibrillin gene but not in those who have the familial form of the disease. We describe here 2 patients, from the same family (siblings), diagnosed with gigantic aortic aneurysm early in infancy, one of them successfully undergoing surgery.
The preservation of internal iliac artery (IIA) flow during endovascular repair of abdominal aortic aneurysms (er-AAA) remains a controversial area. Ectasia and aneurysmal disease of the iliac arteries represent a formidable challenge to the endovascular surgeon, particularly when aortic neck length and diameter are suitable for er-AAA. We describe a procedure to maintain arterial perfusion to the pelvis during er-AAA called retrograde endovascular hypogastric artery preservation (REHAP). This technique is particularly useful in the presence of common iliac artery (CIA) and internal iliac artery (IIA) aneurysms when pelvic perfusion to one IIA needs to be maintained. A Wallgraft is first placed from the IIA to the ipsilateral EIA followed by er-AAA using an aortouniiliac graft (AUI) and a femorofemoral bypass graft (BPG). This procedure represents one alternative to maintaining pelvic perfusion using standard endovascular and surgical techniques.
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