Fenestrated and branched stent-grafting after previous surgery provides a good alternative to open redo surgery

Autor: Bjorn I. Oranen, W. T. G. J. Bos, J.J.A.M. van den Dungen, I. F. J. Tielliu, Frans L. Moll, Ted R. Prins, Bart E. Muhs, Clark J. Zeebregts, E.L.G. Verhoeven
Přispěvatelé: Man, Biomaterials and Microbes (MBM), Vascular Ageing Programme (VAP)
Jazyk: angličtina
Rok vydání: 2007
Předmět:
Male
Time Factors
salvage surgery
medicine.medical_treatment
open aneurysm repair
OPEN REPAIR
Endovascular aneurysm repair
Severity of Illness Index
open surgery
juxtarenal
EVAR
Medicine(all)
Abdominal aortic aneurysm
Treatment Outcome
suprarenal
AORTIC PROSTHETIC RECONSTRUCTION
cardiovascular system
Female
Stents
Radiology
Cardiology and Cardiovascular Medicine
Reoperation
medicine.medical_specialty
branched endograft
ANASTOMOTIC ANEURYSMS
fenestrated
JUXTARENAL ANEURYSMS
Anastomosis
Prosthesis Design
Blood Vessel Prosthesis Implantation
Aneurysm
abdominal aortic aneurysm
Angioplasty
Severity of illness
medicine
Vascular Patency
Humans
cardiovascular diseases
Aortic Aneurysm
Thoracic
business.industry
branched
Length of Stay
medicine.disease
Surgery
Redo surgery
ENDOVASCULAR TREATMENT
aneurysm
fenestrated endograft
business
Tomography
X-Ray Computed
Aortic Aneurysm
Abdominal
Follow-Up Studies
Zdroj: European Journal of Vascular and Endovascular Surgery, 33(1), 84-90. W B SAUNDERS CO LTD
ISSN: 1078-5884
Popis: Objective. To present our experience using fenestrated and branched endoluminal grafts for Para-anastomotic aneurysms (PAA) following prior open aneurysm surgery, and after previous endovascular aneurysm repair (EVAR) complicated by proximal type I endoleak.Methods. Fenestrated and/or branched EVAR was performed on eleven patients. Indications included proximal type I endoleak after EVAR and short infrarenal neck (n = 4), suprarenal aneurysm after open AAA (n = 4), distal type I endoleak after endovascular TAA (n = 1), proximal anastomotic aneurysm after open AAA (n = 1), and an aborted open AAA repair due to bleeding around a short infrarenal neck.Results. The operative target vessel success rate was 100% (28/28) with aneurysm exclusion in all patients. Mean hospital stay was 6.0 days (range 2-12 days, SD 3.5 days). Thirty day mortality was 0%. All cause mortality during 18 months mean follow-up (range 5-44 months, SD 16.7 months) was 18% (2/11) with no deaths from aneurysm rupture. Cumulative visceral branch patency was 96% (27/28) at 42 months. Average renal function remained unchanged during the follow-up period.Conclusions. Our report highlights the potential of fenestrated and branched technology to improve re-operative aortic surgical outcomes. The unique difficulties of increased graft on graft friction hindering placement, short working distance, and increased patient co-morbidities should be recognized.
Databáze: OpenAIRE
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