Abdominal Aortic Aneurysms: Experience with the Ivancev-Malmö Endovascular System for Aortomonoiliac Stent-Grafts
| Autor: | K, Ivancev, M, Malina, B, Lindblad, T A, Chuter, J, Brunkwall, M, Lindh, U, Nyman, B, Risberg |
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| Rok vydání: | 1997 |
| Předmět: |
Aged
80 and over Angiography Digital Subtraction Middle Aged 030204 cardiovascular system & hematology Aortography Iliac Artery Blood Vessel Prosthesis 030218 nuclear medicine & medical imaging 03 medical and health sciences Postoperative Complications Treatment Outcome 0302 clinical medicine Foreign-Body Migration Iliac Aneurysm Humans Stents Radiology Nuclear Medicine and imaging Surgery Tomography X-Ray Computed Cardiology and Cardiovascular Medicine Aged Aortic Aneurysm Abdominal Retrospective Studies |
| Zdroj: | Journal of Endovascular Therapy. 4:242-251 |
| ISSN: | 1545-1550 1526-6028 |
| DOI: | 10.1177/152660289700400303 |
| Popis: | Purpose: To describe a component-based aortomonoiliac stent-graft system and the first clinical results achieved with this device in endovascular abdominal aortic aneurysm (AAA) repair. Methods: From November 1993 to October 1996, 45 patients aged 60 to 86 years underwent endoluminal exclusion of true AAAs (median diameter 60 mm) involving the common iliac arteries (median diameter 16 mm right and 15 mm left) using unilimb stent-grafts deployed with the Ivancev-Malmö system. Results: Six immediate conversions occurred in the beginning of the series due to endografts that were too short. Complications, including 2 inadvertent renal artery occlusions, 7 kinked grafts, 6 iliac artery dissections, and 3 perioccluder leaks, were prominent features in the first 15 patients. Five patients died in the postoperative period, four of whom were nonsurgical candidates. There were five significant stent-graft migrations: one 3 weeks after surgery due to mechanical injury of the proximal stent and four after 1 year owing to continuous dilation of a wide proximal neck, stent-graft placement in a conical, thrombus-lined proximal neck, and two instances of proximal extension separation from the main graft. Translumbar aneurysm perfusion required embolization in 3 patients. Conclusions: Despite early complications associated with a learning curve, exclusion of large AAAs using unilimb stent-grafts is feasible. Strict inclusion criteria are necessary in order to improve mortality among nonsurgical candidates and minimize the risk for late migration. |
| Databáze: | OpenAIRE |
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