At the end of 2010, we successfully rescued a critically ill patient with a ruptured abdominal aortic aneurysm using minimally invasive endoluminal techniques. The level of abdominal aortic aneurysm salvage in our hospital has entered a new stage. People can’t help but wonder: What is an abdominal aortic aneurysm? Why is this abdominal aortic aneurysm so risky? How difficult is it to save a ruptured abdominal aortic aneurysm. One day in November 2010, 7:30 p.m., the whistling 120 ambulance brought an elderly patient with abdominal pain, and after a tense and orderly simple treatment in the emergency room, Dr. Yu Shenghua, who received the patient, realized that this patient was a very critical patient: the patient’s abdominal pain continued, blood pressure began to be low, and the heartbeat began to accelerate, and the CT was done outside the hospital to diagnose a ruptured abdominal aortic aneurysm. There was no time to lose, so Dr. Yu immediately sent the patient to the inpatient unit using the green channel. By this time, the patient’s blood pressure was already 50/30 mmHg and he was already in shock. In the ICU, the doctor and ICU colleagues quickly and skillfully performed anti-shock treatment, and at the same time called in vascular surgery expert Yang Chengyu, the director, to begin active preparation for surgery. After a series of anti-shock treatments, the patient’s blood pressure improved slightly and the preparation for surgery was completed. At 9:00 pm, the surgery started. The operation was a minimally invasive “abdominal aortic aneurysm endoluminal isolation”, which means that the abdominal aortic aneurysm was repaired with a stent in the vascular cavity using an interventional method, and the operation was finally successful after more than 3 hours of intense surgery despite the difficulties. The patient was transferred back to the general ward from the ICU the day after the surgery, and was able to get out of bed on the fourth day, and was discharged from the hospital after seven days of stitch removal. What is abdominal aortic aneurysm? An abdominal aortic aneurysm is a dilated bulge in the wall of the abdominal aorta. Abdominal aortic aneurysms can grow in size and eventually rupture and bleed, resulting in the patient’s death. Abdominal aortic aneurysms occur mainly in older people over 60 years of age, in a ratio of 10:3 between men and women, and are often associated with hypertension and heart disease, although they are also occasionally seen in younger people. They are more common in men than in women. Other rare causes are congenital dysplasia of the aorta, syphilis, trauma, infection, aortitis, and Marfan syndrome. The abdominal aorta is the thickest artery in the body. Abdominal aortic aneurysm is not a tumor growing on the abdominal aorta, but a tumor in which the wall of the abdominal aorta is damaged by some pathological factors, and the high speed and high pressure of the aortic blood flow causes it to expand, and after it expands to a certain extent, the wall of the vessel becomes thin and finally ruptures, leading to bleeding and death of the patient. Although it has the title of “aneurysm”, it is very different from a tumor. Why is this abdominal aortic aneurysm so risky? 80% of patients die after bleeding. “Patients are lucky!” As an abnormal dilatation of an artery, a coarctation aneurysm is neither malignant nor benign, but it ruptures and kills with a ferocity that makes it difficult for any tumor to hope for. Abdominal aortic aneurysms are known as untimely bombs in the body and are extremely dangerous if they rupture. Generally speaking, about 50% of patients with ruptured aneurysms die before they are seen, 80% die despite aggressive treatment, and only 10% are fortunate enough to recover well – and the patient is one of those 10%. What are the difficulties in resuscitating a ruptured abdominal aortic aneurysm? The main difficulty lies in the fact that the patient is already bleeding heavily before surgery and is poorly tolerant of surgery. In the past, most open surgery methods were used, which were highly traumatic and exposed the patient to secondary bleeding after opening the abdominal cavity. And it is difficult to control. However, due to the urgency of the operation and the lack of necessary preoperative examination and evaluation, the difficulty of the operation was greatly increased, requiring the surgeon to be extremely skilled, able to quickly stop the bleeding intracavernally, quickly evaluate, and complete the operation as soon as possible. Two weeks ago, we used this technique to successfully save a second patient with a ruptured abdominal aortic aneurysm. This marks the growing maturity of this technique in our hospital. Conclusion – Dismantle the time bomb, take action The disease is like a time bomb in the body, once ruptured, the mortality rate is as high as 50%-80%. Most patients are found during physical examination with a pulsating mass in the abdomen. First of all, we should actively prevent the occurrence of atherosclerosis (primary prevention), and if it has already occurred, we should actively treat it to prevent the development of the lesion and strive for its reversal (secondary prevention). If complications have already occurred, timely treatment should be given to prevent their deterioration and prolong the patient’s life (tertiary prevention). Abdominal aortic aneurysms cannot be cured by drugs, and surgery is the only effective method to treat aneurysms. Minimally invasive endoluminal repair can achieve a cure by introducing a stent into the artery with the aneurysm, isolating the blood flow from the aneurysm sac and wall, and the blood flow flows through the stent without impacting the aneurysm sac anymore. Patients with abdominal aortic aneurysms must be detected early, treated early, and isolated early, and can live well with the aneurysm as well.