The use of thoracic stent grafts for endovascular repair of abdominal aortic aneurysms
| Autor: | R. C. van Nieuwenhuizen, Anco C. Vahl, Vanessa J. Leijdekkers, M.G. Snoeijs, J. G. A. M. Blomjous, V. P. Bastiaenen, Jan Bosma |
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| Přispěvatelé: | RS: CARIM other, MUMC+: MA Med Staf Spec Vaatchirurgie (9) |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Endoleak medicine.medical_treatment 030204 cardiovascular system & hematology Endovascular aneurysm repair 0302 clinical medicine EVAR 030212 general & internal medicine thoracic endograft Aged 80 and over OUTCOMES medicine.diagnostic_test Endovascular Procedures wide infrarenal neck General Medicine Middle Aged Abdominal aortic aneurysm ANATOMY Treatment Outcome surgical procedures operative NECKS cardiovascular system Open repair Female Stents Cardiology and Cardiovascular Medicine Reoperation medicine.medical_specialty funnel technique Prosthesis Design 03 medical and health sciences Aneurysm abdominal aortic aneurysm medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Aged Aortic Aneurysm Thoracic business.industry Stent medicine.disease RANDOMIZED-TRIAL Surgery Angiography business Aortic neck Aortic Aneurysm Abdominal |
| Zdroj: | Vascular, 26(3), 278-284. SAGE Publications Ltd |
| ISSN: | 1708-5381 |
| DOI: | 10.1177/1708538117733909 |
| Popis: | Objectives Stent grafts for endovascular repair of infrarenal aneurysms are commercially available for aortic necks up to 32 mm in diameter. The aim of this study was to evaluate the feasibility of endovascular repair with large thoracic stent grafts in the infrarenal position to obtain adequate proximal seal in wider necks. Methods All patients who underwent endovascular aneurysm repair using thoracic stent grafts with diameters greater than 36 mm between 2012 and 2016 were included. Follow-up consisted of CT angiography after six weeks and annual duplex thereafter. Results Eleven patients with wide infrarenal aortic necks received endovascular repair with thoracic stent grafts. The median diameter of the aneurysms was 60 mm (range 52–78 mm) and the median aortic neck diameter was 37 mm (range 28–43 mm). Thoracic stent grafts were oversized by a median of 14% (range 2–43%). On completion angiography, one type I and two type II endoleaks were observed but did not require reintervention. One patient experienced graft migration with aneurysm sac expansion and needed conversion to open repair. Median follow-up time was 14 months (range 2–53 months), during which three patients died, including one aneurysm-related death. Conclusions Endovascular repair using thoracic stent grafts for patients with wide aortic necks is feasible. In these patients, the technique may be a reasonable alternative to complex endovascular repair with fenestrated, branched, or chimney grafts. However, more experience and longer follow-up are required to determine its position within the endovascular armamentarium. |
| Databáze: | OpenAIRE |
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