Endovascular Repair of Juxta and Suprarenal Aortic Aneurysm

Abstract

Juxta and Suprarenal aortic aneurysm is one of major vascular problems in which management is considered challenge for vascular surgeons as It usually affect elderly patients with other comorbidities as ischemic heart disease and chronic obstructive pulmonary disease . Management of Juxta and Suprarenal aortic aneurysm can be done by: • Conservative Management: Indicated for aneurysms less than 5.5 cm in asymptomatic patients. This includes smoking cessation, blood pressure control, medications as; Beta blockers, Doxycycline & statins. Follow up is required every 6 months for surveillance of the aneurysm. • Surgery : It offers complete cure of the aneurysm. However, juxta and suprarenal aortic aneurysm usually affect elderly people who are usually unfit for surgery, and inspite of great advances in anaesthesiology and postoperative care morbidity and mortality is still high . • Endovascular repair : Endovascular repair of juxta and suprarenal aortic aneurysm was originally developed for patients who were considered to be physically ineligible for open surgical repair. F-EVAR represents a feasible option for the repair of juxta and suprarenal aortic aneurysm. It is advantageous in terms of mortality and less morbid than open surgery, but is associated with increased technical challenges because of the previously placed stent graft. Outcome seems related to initial technical success.