Retrograde Target Vessel Catheterization as a Salvage Procedure in Fenestrated/Branched Endografting
| Autor: | Hermann Renner, Eric L.G. Verhoeven, Athanasios Katsargyris, Clayton J. Brinster, Kyriakos Oikonomou, Wolfgang Ritter |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Juxtarenal aortic aneurysm Target vessel Catheterization Blood Vessel Prosthesis Implantation Postoperative Complications Renal Artery Celiac Artery medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Thoracoabdominal aneurysm Aged Salvage Therapy business.industry Length of Stay Middle Aged Salvage procedure Surgery Aortic Aneurysm Blood Vessel Prosthesis Mesenteric Arteries Radiography Treatment Outcome Female Stents Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists. 22(4) |
| ISSN: | 1545-1550 |
| Popis: | Purpose: To present retrograde target vessel catheterization as a bailout technique in fenestrated and branched endografting (F/B-EVAR). Methods: Between November 2003 and November 2014, 11 (1.6%) of 671 consecutive patients with juxtarenal, suprarenal, and thoracoabdominal aortic aneurysms required retrograde target vessel access as a bailout measure during F/B-EVAR due to failure of an antegrade approach. The target vessels involved the left renal artery (LRA) in 6 patients, the celiac artery (CA) in 3 patients, the right renal artery (RRA) in 1 patient, and both renal arteries in 1 patient. Results: The target vessels were successfully catheterized and secured with stent-grafts in 10 patients; a single case was unsuccessful because the fenestration was in the wrong position and blocked against the arterial wall. One (9.1%) patient died within 30 days. Major perioperative complications occurred in 6 patients, including 3 with renal function deterioration, 2 with access-site wound dehiscence, and a case of pneumonia. Median hospital stay was 20 days (range 7–60) and median intensive care unit stay was 2.5 days (range 0–9). Over a mean 26-month follow-up (range 1–60), one unrelated death occurred. Reintervention was required in 1 patient due to progression of an aneurysm of the right iliac artery. Conclusion: Retrograde target vessel access in F/B-EVAR is a feasible bailout procedure when antegrade cannulation fails. Secondary technical success is high, but the procedure is associated with higher perioperative morbidity and longer hospital stay. |
| Databáze: | OpenAIRE |
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