title: Neck remodeling using the amplatzer vascular plug to facilitate endovascular repair of a contained abdominal aortic rupture.
abstract: OBJECTIVE
  To describe the use of an Amplatzer Vascular Plug to facilitate endovascular aneurysm repair (EVAR) in a renal transplantation recipient with contained rupture of an abdominal aortic aneurysm (AAA).
  
  
  METHODS
  A 52-year-old man with a history of kidney transplantation and a 4-cm AAA was referred to our hospital with severe abdominal pain. Imaging showed the contained AAA rupture measuring 8 cm, with 2 blisters at the proximal short neck and narrow calcified iliac arteries. The blisters were the probable sites of rupture, and the cranial one was 4 mm below the superior mesenteric artery, precluding conventional EVAR. The Amplatzer Vascular Plug was used to occlude the blister and remodel the proximal neck so that a low-profile Ovation prosthesis could be passed through the narrow calcified iliac artery without damaging the transplanted renal artery anastomosed to the external iliac artery.
  
  
  CONCLUSIONS
  The unconventional use of the Amplatzer Vascular Plug for neck remodeling made EVAR possible in this case.
authors: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology, and Radiation Therapy, University Hospital Tor Vergata, Rome, Italy.
authors: Roberto
authors: R
authors: Gandini
authors: Enrico
authors: E
authors: Pampana
authors: Matteo
authors: M
authors: Stefanini
authors: Sergio
authors: S
authors: Spano
authors: Fabio
authors: F
authors: Martinelli
authors: Daniele
authors: D
authors: Citraro
authors: Giovanni
authors: G
authors: Simonetti
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery*; D001019:Aortic Rupture / Q000150:complications / Q000601:surgery*; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055989:Septal Occluder Device