STATE OF THE ART PAPER
Spontaneous avulsion of the inferior mesenteric artery in a neurofibromatosis type 1 patient: a case-based review
1
Department of Vascular Surgery, General University Hospital of Patras, Patras, Greece
2
Department of Oncology, General University Hospital of Patras, Patras, Greece
3
Department of General Surgery, General University Hospital of Patras, Patras, Greece
4
Department of Surgery, General Hospital of Lamia, Lamia, Greece
5
Department of Cardiothoracic and Vascular Surgery, Westpfalz Klinikum, Kaiserslautern, Germany
6
Department of Radiology, General University Hospital of Patras, Patras, Greece
7
Department of Anesthesiology, General University Hospital of Patras, Patras, Greece
8
Department of Neurology, General University Hospital of Patras, Patras, Greece
9
Department of Pathology, School of Medicine, University of Patras, Patras, Greece
Submission date: 2025-01-22
Final revision date: 2025-02-26
Acceptance date: 2025-05-12
Publication date: 2025-06-02
Corresponding author
Arch Med Sci Atheroscler Dis 2025;10(1):48-68
KEYWORDS
endovascular repairaortic ruptureabdominal aortic aneurysmneurofibromatosis type 1von Recklinghausen’s diseaseiliac aneurysmiliac rupture
TOPICS
ABSTRACT
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.
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