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Massive atheroemboliaafter CO2 EVAR
Alejandro Fabiani
Director Vascular Medicine Center
Clinic Professor of Vascular Surgery
Hospital Zambrano Hellion,
Tec School of Medicine, Monterrey, México
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Disclosure
Speaker name:
Alejandro Fabiani
I have the following potential conflicts of interest to report:
X Consulting BMC
Employment in industry
Stockholder of a healthcare company
Owner of a healthcare company
x Other(s): Proctor and Speaker for Bolton, Cook Medical,
Endologix, Medtronic.
I do not have any potential conflict of interest
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•82 years old male
•Presented with embolia to the fifth toe
•CRF : Cr 2.4 mg%
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Symptomatic 50.5 mm AAA & 18 mm LCIA
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After EVAR
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After EVAR
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Atheroembolia?
CO2?
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Labs:
Hb 12.5
Cr 2.7
pH 7.36
CO2 42
EB -3
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Treatment:
Alprostadil-Prostaglandin E1(80 μg
IV/day)
Steroids
Hemodinamic support
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4 hours after EVAR
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4 hours after EVAR
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12 hours after EVAR
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24 hours after EVAR
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Days 2-3 after EVAR
Patient was improving
Referred no pain/discomfort
Labs were within normal parameters
But…
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Day 4 after EVAR
Abdominal pain & distension
Oliguria
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Patient died on day 6 after
EVAR
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Thanks
drfabiani.com
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Massive atheroemboliaafter CO2 EVAR
Alejandro Fabiani
Director Vascular Medicine Center
Clinic Professor of Vascular Surgery
Hospital Zambrano Hellion,
Tec School of Medicine, Monterrey, México