Pregnant Patient With Infrarenal Abdominal Aortic Aneurysm Successfully Treated With EVAR.

BACKGROUND

Pregnancy management in patients with a history of untreated aortic aneurysm or dissection is not established.

CLINICAL CONDITION: A patient with a chronic infrarenal abdominal aortic aneurysm and dissection was referred to our hospital at 13 weeks' gestation.

KEY QUESTIONS: What are the treatment options for infrarenal abdominal aortic aneurysm with dissection in a pregnant patient? What tests are needed for treatment strategy? What are the safety considerations when performing endovascular aneurysm repair (EVAR) during pregnancy?

OUTCOME: Genetic testing for established hereditary aortopathy genes was negative. After carvedilol treatment, EVAR was performed under ultrasound guidance with minimal radiation exposure at 19 weeks' gestation, allowing for adequate fetal growth. She had an uncomplicated vaginal delivery under epidural anesthesia at 39 weeks' gestation.

TAKE-HOME MESSAGES: EVAR could be an effective treatment option during pregnancy if radiation exposure is properly minimized. Multidisciplinary collaboration, including early evaluation for connective tissue diseases, is essential to evaluate treatment strategy.