Balloon occlusion of the aorta during endovascular repair of ruptured abdominal aortic aneurysm

Purpose: To describe a technique of aortic clamping during endovascular aneurysm repair (EVAR) in patients with ruptured abdominal aortic aneurysms (AAA) and circulatory collapse. Technique: A balloon catheter is inserted percutaneously from the femoral artery and inflated in the suprarenal aorta. An introducer sheath must support the balloon. The stent-graft is passed from the contralateral groin and deployed beneath the balloon. The sheath makes it possible to retrieve the balloon after the endograft has been deployed. Carbon dioxide facilitates angiography while the aortic blood flow is arrested. Conclusions: The aortic stent-graft can be deployed while the aorta is continuously "clamped" from a transfemoral approach. This may allow EVAR in patients with circulatory collapse due to aneurysm rupture.