Rottura di Aneurisma Aortico con precedente Trattamento Endoprotesico

Emergency Surgical Conversion for Rupture of Abdominal Aortic Aneurysms after EVAR - The rare observations of rupture of abdominal aortic aneurysm (AAA), which had been excluded by endograft, are becoming more frequent, because of the spreading use of endovascular aneurysms exclusion (EVAR). Clinical presentation of AAA rupture after EVAR could be misleading, because of the possible plugging by the endograft and delayed haemorrhage, as in the presented clinical case. Some particular surgical techniques can assist the procedure of open repair, such as supra-renal clamping, which can be accomplished by aortic balloon, and arterial reconstruction, sewing a new vascular graft on the proximal and distal segments of the endograft, cut and left in situ, thus avoiding damage to the native arteries and facilitating surgical fixation.