Endovascular AAA Repair With the Aortomonoiliac EndoFit Stent-Graft: Two Years' Experience
| Autor: | Athanasios Lioupis, Dimitrios Lykopoulos, Nikolaos Melas, George Ginis, Polychronis Antonitsis, Nikolaos Saratzis, John Lazaridis, Christos Gitas, Dimitrios Kiskinis |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Prosthesis Design Iliac Artery Blood Vessel Prosthesis Implantation Aneurysm medicine.artery medicine Humans Radiology Nuclear Medicine and imaging Aorta Abdominal Aged Retrospective Studies Aged 80 and over business.industry Anastomosis Surgical Angiography Stent Perioperative Middle Aged Angioscopy medicine.disease Thrombosis Common iliac artery Abdominal aortic aneurysm Surgery Femoral Artery Treatment Outcome Cuff Feasibility Studies Female Stents Radiology Cardiology and Cardiovascular Medicine Paraplegia business Aortic Aneurysm Abdominal Follow-Up Studies |
| Zdroj: | Journal of Endovascular Therapy. 12:280-287 |
| ISSN: | 1545-1550 1526-6028 |
| DOI: | 10.1583/04-1474.1 |
| Popis: | PURPOSE To evaluate the feasibility and efficacy of a specific aortomonoiliac endograft and the durability of the femorofemoral bypass for treatment of abdominal aortic aneurysm (AAA). METHODS From 2002 to 2004, 39 high-risk (ASA III/IV) patients (36 men; median age 74 years, range 63-84) with AAA (n = 33) or AAA and common iliac artery aneurysm (n = 6) were treated with an EndoFit aortomonoiliac endograft and femorofemoral crossover bypass. The contralateral iliac axis was obstructed with an endoluminal occluder. Patients were followed with contrast-enhanced computed tomography at 1, 6, 12, and 24 months. RESULTS EndoFit AMI stent-grafts were implanted successfully in all patients. Perioperative mortality was zero. Endoleak occurred in 3 (7.7%) cases. A proximal type I endoleak was identified at 1 month and was treated with a proximal cuff. Two type II endoleaks are under surveillance because the aneurysm sac shows no enlargement. Thrombosis of the femorofemoral graft occurred in 1 case during the immediate postoperative period due to insufficient inflow from a residual stenosis of the endograft (primary patency 97.5%). The deficit was treated successfully (secondary patency 100%). Two (5.1%) tunnel hematomas were treated conventionally. Median follow-up was 14 months (range 6-30). All patients are alive. None of the aneurysms has ruptured or been converted to an open procedure. Graft migration, serious infection, paraplegia, distal embolization, or any other serious complication has not been observed. CONCLUSIONS In high surgical risk patients with complex iliac anatomy, aortomonoiliac endograft with femorofemoral crossover bypass is feasible and efficacious. Moreover, the midterm patency of the extra-anatomic bypass appears quite satisfactory. |
| Databáze: | OpenAIRE |
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