Manipal Hospital Mukundapur Saves Bangladeshi Patient from Life-Threatening Giant Aortic Aneurysm with Minimally Invasive Procedure

Kolkata:  Manipal Hospital Mukundapur has successfully treated a 54-year-old man from Bangladesh suffering from renal complications and a rare, life-threatening giant infrarenal abdominal aortic aneurysm (a large balloon-like bulge in the abdominal aorta, the body's main blood vessel, located below the arteries supplying the kidneys). The patient initially presented with kidney-related issues and was evaluated by Dr. Avinandan Banerjee, Clinical Lead – Nephrology & Kidney Transplant  Manipal Hospital Mukundapur. During evaluation, complex vascular condition was identified and owing to the severity and complexity of the aneurysm, the patient was referred for advanced vascular intervention. A highly advanced, minimally invasive Endovascular Aortic Repair (EVAR) procedure was then successfully performed by Dr. Soumya Patra, Senior Consultant – Cardiology and Director – Cath Lab, and Dr. Arijit Datta, Senior Consultant - Cardiothoracic and Vascular Surgery Specialist, Manipal Hospital Mukundapur.

Fedu Saha, a 54-year-old active smoker with a history of coronary artery bypass graft (CABG) surgery in 2016, was admitted to Manipal Hospital Mukundapur on 5th July 2026 after experiencing severe abdominal pain radiating to his back and left lower limb, along with increasing difficulty in walking. A CT angiography revealed a giant aneurysm of the infrarenal abdominal aorta, with mural thrombus and dissection, a giant bulge in the lower section of the body's main artery that supplies blood to the lower half of the body, with a blood clot along its inner wall and a tear in the artery's lining. The aneurysm had significantly compromised blood flow, particularly to the left femoral artery compared to the right, while the upper abdominal aorta remained normal. Due to its size, the aneurysm was also compressing adjacent structures, contributing to the patient's severe pain and mobility issues.

After a comprehensive evaluation, the treating team decided to perform a completely percutaneous Endovascular Aortic Repair (EVAR) on 6th July 2026 using an Endovascular Graft (a fabric-covered metal mesh tube that is placed inside a damaged blood vessel to reinforce). During the procedure, the stent graft was positioned inside the diseased segment of the aorta, creating a new pathway for blood flow while excluding the aneurysm sac from circulation. This prevented further expansion of the aneurysm and significantly reduced the risk of rupture. Unlike conventional open surgery, the entire procedure was performed through small punctures in the blood vessels without the need for a large abdominal incision or laparotomy. Advanced MANTA vascular closure devices were used to seal the access sites, enabling faster recovery with minimal postoperative discomfort.

Speaking about the case, Dr. Soumya Patra said, "Large abdominal aortic aneurysms are potentially fatal because they can rupture without warning, causing life-threatening internal bleeding. In this patient, the aneurysm had already begun affecting blood flow to the lower limb, leading to severe pain and difficulty in walking. Performing a completely percutaneous EVAR allowed us to safely exclude the aneurysm while preserving blood flow through the aorta, avoiding the trauma and prolonged recovery associated with open surgery. Such advanced endovascular procedures are transforming the management of complex vascular diseases by offering safer treatment with quicker recovery and excellent clinical outcomes."

Dr. Arijit Datta, shared, "Abdominal aortic aneurysms are often referred to as a 'silent killer' because they may remain asymptomatic until they enlarge significantly or rupture. Early diagnosis through timely imaging is crucial, particularly in individuals with risk factors such as smoking, advancing age and a history of cardiovascular disease. In this case, the aneurysm had already begun compromising blood flow to the lower limb, but had also developed a dissection, a tear in the inner wall of the aorta which significantly increased the risk of life-threatening complications and made urgent intervention essential. The close collaboration between our vascular surgery and interventional cardiology teams enabled us to offer a minimally invasive solution that eliminated the need for open surgery while ensuring a safe and effective outcome for the patient.”

The patient's postoperative recovery was uneventful, and he was discharged on 9th July 2026 in stable condition. At follow-up, he reported a significant reduction in pain and was able to walk comfortably, marking a remarkable improvement in his quality of life.

This successful intervention underscores Manipal Hospital's expertise in managing complex vascular disorders through advanced endovascular techniques, offering patients cutting-edge, minimally invasive treatment options with improved safety, shorter hospital stays and faster recovery.

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