Endovascular stent-graft exclusion of adult giant patent ductus arteriosus through a hybrid transabdominal approach.

Endovascular stent-graft exclusion has proven to be a safe and effective alternative for adult patients with patent ductus arteriosus. We present a case of a 38-year-old woman with a large, symptomatic ductus. However, her small femoral and iliac arteries limited the access options. The patient underwent laparotomy and end-to-side anastomosis of a Dacron graft to the abdominal aorta. Then, the laparotomy was temporarily closed with the graft externalized, and the patient was transported to the radiology suite for successful stent-graft deployment. This hybrid transabdominal approach may be preferred in patients without suitable peripheral arteries to accommodate the device.