Chronic Contained Rupture of an Abdominal Aortic Aneurysm Causing Vertebral Erosion: Two Case Reports

We report here two cases of a chronic contained rupture of an infrarenal abdominal aortic aneurysm (CCR-AAA) which eroded a lumbar vertebra. One patient underwent a graft replacement of the aneurysm without any orthopedic intervention and remains in good health 4 years after the operation with improvement to the vertebral injury. Another patient underwent endovascular aortic repair (EVAR) without orthopedic spine stabilization due to his poor general condition. Afterwards, a remaining type II endoleak possibly progressed vertebral destruction. The patient became bedridden and died of pneumonia 21 months later. Surgery is necessary to prevent the re-rupture of CCR-AAA. However, EVAR could be an incomplete treatment in respect of its insufficient decompression of intra-aneurysmal pressure. Graft replacement should be considered to be the principle procedure for this often fatal condition.