Spontaneous avulsion of the inferior mesenteric artery in a neurofibromatosis type 1 patient: a case-based review.

We present the case of successful endovascular abdominal aortic aneurysm repair (EVAR) in a 55-year-old male who presented with a ruptured infrarenal aortic pseudoaneurysm, formed after spontaneous avulsion of the inferior mesenteric artery. The avulsion occurred after lifting a heavy object. Although aortic endografting is not the first option in patients with hereditary disorders due to aortic friability and concerns about long-term durability, it is valuable in urgent cases due to lower morbidity and mortality, even as a bridging procedure. This policy is further supported by the fact that the alternative open reconstruction has been invariably associated with hemostasis issues and poor outcomes due to arterial fragility and inability to construct safe anastomoses. Finally, we present a current literature review regarding abdominal aortic and iliac pathology in patients with neurofibromatosis type 1 focusing on the type of the vascular lesion, method of repair and outcome.