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Presentation. 61 y/o male with severe abdominal pain, outside non-con CT demonstrates ruptured AAA Patient not intubated awake and alert, BP currently stable in 120’s systolic, weakly palpable femoral pulses Patient brought to Stanford by helicopter

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  1. Presentation • 61 y/o male with severe abdominal pain, outside non-con CT demonstrates ruptured AAA • Patient not intubated awake and alert, BP currently stable in 120’s systolic, weakly palpable femoral pulses • Patient brought to Stanford by helicopter • Patient immediately brought to the operating room, abdomen distended but not tense, femoral pulses weak, popliteal and distal pulses not palpable • Medical history unknown at the time • Patient arrived with CT scan

  2. Outside CT scan • Neck – angulated 22 to 23mm with about 10mm seal zone • Patient left most renal to closest hypogastric artery >190mm • Common iliac artery measures 18mm on right, 16mm on the left

  3. Pre-deployment of GORE 28.5 x 14.5 x 160 main body

  4. Contra limb on the right is 14.5 x 100mm Then extended with 20 x 140mm cuff

  5. Ipsilateral cuff with 20 x 120mm cuff

  6. Post-operative course • Patient monitored in ICU with abdominal pressure checked regularly • Patient transferred to floor POD#2, discharged to home POD#5

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