Perioperative changes of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in surgically treated cases of abdominal aortic aneurysm (AAA) were investigated. A retrospective review of 34 patients of AAA who underwent operation was carried out. All patients received cardiac catheterization before the AAA operation. ANP and BNP were measured on the preoperative day, postoperative day (POD) 1 and POD 2, respectively. Twenty-two cases were complicated by ischemic heart disease (IHD). In all cases of AAA, ANP and BNP increased significantly at POD 1 and POD 2. The levels of ANP and BNP in the AAA with IHD group were significantly higher than those in the AAA without IHD group at all points. These results suggest that postoperative care for cardiac overload during the AAA operation is especially needed for patients with IHD.

A 75-year-old man was admitted complaining of sudden bilateral foot coldness and numbness. The patient had undergone endovascular repair for abdominal aortic aneurysm (AAA) 5 years previously. Abdominal X-ray showed a highly kinked endovascular stent-graft, and aortography revealed occlusion of the stent-graft and infrarenal aorta. Emergency axillo-bifemoral bypass was performed to restore the blood flow of the lower extremities, and he recovered uneventfully. Endovascular repair for AAA can be performed with low mortality and morbidity, and is accepted worldwide as a minimally invasive treatment. However, there are several late complications, such as newly developed endoleak, graft migration, graft occlusion, AAA expansion, and AAA rupture. Therefore, great attention should be paid to following patients treated with endovascular procedures for abdominal aortic aneurysm.