Nonresective therapy for abdominal aortic aneurysm in the high-risk patients case reports

Three high-risk patients with an abdominal aortic aneurysm have been man aged with nonresective treatment, including ligation of femoral arteries and, in 2 cases, introduction of Gianturco-Wallace coils into the sac, to induce acute thrombosis of the AAA, and an axillo-bifemoral bypass for restoration of arte rial flow to the lower limbs. One patient died postoperatively. The literature on this alternative treatment is reviewed. It is stressed that there are a high mortality rate and a high incidence of serious and often lethal complications and that rupture of the aneurysm is not fully precluded. Thus noresective treatment of AAA has to be used with extreme precaution in high- risk patients.