Outcomes of endovascular repair of abdominal aortic aneurysms in narrow aortic bifurcations using the ultra-low profile 'INCRAFT' device: A retrospective multicenter study
| Autor: | Gianluca Citoni, Vittorio Alberti, Nicola Mangialardi, Arnaldo Ippoliti, Sonia Ronchey, Stefano Bartoli, Yamume Tshomba, Matteo Orrico |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Databases Factual Technical success 030204 cardiovascular system & hematology Iliac Artery Blood Vessel Prosthesis Implantation 03 medical and health sciences 0302 clinical medicine Risk Factors Complete occlusion medicine Humans EVAR In patient Low-profile endograft 030212 general & internal medicine Vascular Patency Aged Retrospective Studies Abdominal aortic aneurysm Aortic stenosis Iliac stenosis Aged 80 and over business.industry Endovascular Procedures Retrospective cohort study Aortic bifurcation Vascular surgery medicine.disease Settore MED/22 - CHIRURGIA VASCOLARE Blood Vessel Prosthesis Surgery Settore MED/22 Treatment Outcome medicine.anatomical_structure Multicenter study Female Stents Cardiology and Cardiovascular Medicine business Aortic Aneurysm Abdominal |
| Zdroj: | Journal of Vascular Surgery. 72:122-128 |
| ISSN: | 0741-5214 |
| DOI: | 10.1016/j.jvs.2019.09.033 |
| Popis: | Although the long-term results of endovascular aortic repair (EVAR) with low-profile devices in patients with hostile iliac anatomies have been published, there are no reported results specifically for narrow aortic bifurcations (NAB). This study investigated the outcomes of EVAR with the INCRAFT device in NAB (16 mm).This multicenter retrospective study involved five vascular surgery centers. From November 2014 until June 2018, 127 patients were treated with the INCRAFT device. The patient population was divided into two groups based on aortic bifurcation diameter. They were designated as the (1) standard aortic bifurcation (SAB) group (16 mm) and the (2) the NAB group (16 mm). Primary end points were the differences between the two groups in terms of technical success, survival at 30 days, iliac limb patency, and reinterventions.The SAB group included 96 patients and the NAB group included 31 patients. The mean aortic bifurcation diameter was 25.5 mm in the SAB group and 13.2 mm in the NAB group. It is noteworthy that, in the NAB group, 21.8% of patients had aortic bifurcations with focal calcific lesions (less than one-third of the circumferential length of the bifurcation) and 48.3% showed extensive calcifications (two-thirds of the circumferential length of the bifurcation), for 29.9% of the patients in the NAB group the aortic bifurcation had a circumferential highly calcific lesion (complete occlusion of the circumferential length of the bifurcation). Technical success was 98.9% in the SAB group and 96.7% in the NAB group (P = .1). The need for iliac component stenting was not significantly different between the groups (SAB 2.0% vs NAB 3.2%; P = .07). The 1-year survival was 97.9% and 96.7% in the SAB and NAB groups, respectively, with no aneurysm-related mortality. The mean follow-up was 18.4 months and 15.3 months in the SAB and NAB groups, respectively. The iliac primary patency was 98.9 % in the SAB group and 96.8% in the NAB group (P = .088), and the primary assisted patency was 100% in both groups.EVAR with INCRAFT in NABs showed acceptable results. In this multicenter study, the results were comparable in terms of technical success and iliac patency rate between patients with SABs and NABs. |
| Databáze: | OpenAIRE |
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