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Ho CL, Lin JM, Hsu CH, Lin YC. A Comparison of the Short-Term Outcomes After use of Aorto-Uni-Iliac Versus Bifurcated Endografts for Endovascular Repair of Ruptured Abdominal Aortic Aneurysms. Ann Vasc Surg 2023; 89:216-221. [PMID: 36270549 DOI: 10.1016/j.avsg.2022.09.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 09/19/2022] [Accepted: 09/24/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND To compare short-term outcomes of endovascular aneurysm repair (EVAR) with aorto-uni-iliac (AUI) versus bifurcated (BIFUR) endografts in ruptured abdominal aortic aneurysm (rAAA). METHODS A total of 26 rAAA patients receiving EVAR with AUI device (14 patients) or the BIFUR graft (12 patients) between January 2016 and December 2020 were enrolled and reviewed. All EVARs for rAAA were performed in an emergency basis. Graft implantation success, short-term survival rates, and major complications were analyzed. RESULTS Endograft implantation success was achieved in all patients. AUI group had shorter operative time than BIFUR group (121.77 ± 75.03 vs. 138.45 ± 143.34; P < 0.05). The 24-hr and 30-day survival rates were 85.7% (12/14) and 71.4% (10/14), respectively, whereas BIFUR group have 58.3% and 58.3%. None of the rAAA patients in both groups required reintervention. AUI group exhibited less incidence of compartment syndrome and endoleak compared with those of BIFUR ones. CONCLUSIONS The short-term results of EVAR with the AUI configuration graft in patients with rAAAs are encouraging.
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Affiliation(s)
- Ching-Lin Ho
- Surgical Department Cardiovascular Division, China Medical University Hospital, Taiwan, Republic of China
| | - Jiunn-Miin Lin
- Surgical Department Cardiovascular Division, China Medical University Hospital, Taiwan, Republic of China
| | - Chih-Hsiang Hsu
- Surgical Department Cardiovascular Division, China Medical University Hospital, Taiwan, Republic of China
| | - You-Cian Lin
- Surgical Department Cardiovascular Division, China Medical University Hospital, Taiwan, Republic of China; School of Medicine, China Medical University, Taichung, Taiwan, Republic of China.
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Charisis N, Bouris V, Rakic A, Landau D, Labropoulos N. A systematic review on endovascular repair of isolated common iliac artery aneurysms and suggestions regarding diameter thresholds for intervention. J Vasc Surg 2021; 74:1752-1762.e1. [PMID: 33617979 DOI: 10.1016/j.jvs.2021.01.064] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 01/21/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Our aim was to systematically review results of endovascular aneurysm repair for isolated common iliac artery aneurysms (CIAA) regarding outcomes and to determine if changes should be made to current diameter threshold recommendations for intervention. METHODS A comprehensive systematic review was performed according to the PRISMA guidelines. PubMed, Scopus, and the Cochrane Central databases were searched. RESULTS Twenty-one studies were deemed eligible and provided data for 879 patients and 981 isolated CIAA treated with endovascular repair. The majority of the patients (90.8%) were males. The weighted mean age of the patients was 71.7 years (range, 37-91 years). The weighted mean diameter for the CIAA was 41. mm 1 (range, 15-110 mm) and for ruptured aneurysms 58.4 mm. The overall technical success rate was 97.6%. The perioperative mortality rate was 0.7%. Secondary patency rates were reported in only four studies and varied between 96.7% and 100%. The overall morbidity rate was 14%, ranging from 0% to 25%. Most of the studies did not report long-term or adequate follow-up data. Rupture of an isolated CIAA at <4 cm diameter was extremely low. CONCLUSIONS Endovascular treatment of isolated CIAA is feasible and safe with a low mortality and excellent technical success rates. Consideration of increasing the diameter threshold for intervention of CIAA to 4 cm should be considered. Studies with longer follow-up and reliable long-term results are needed.
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Affiliation(s)
| | | | - Alexander Rakic
- Division of Vascular Surgery, Stony Brook Hospitall, Stony Brook, NY
| | - David Landau
- Division of Vascular Surgery, Stony Brook Hospitall, Stony Brook, NY
| | - Nicos Labropoulos
- Division of Vascular Surgery, Stony Brook Hospitall, Stony Brook, NY.
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Nishan B, Sivakrishna K, Vishal H, Ahsan VP, Anand V. Endovascular aneurysm repair with aorto-uni-iliac device: Review of indications and outcomes with a case report of the deployment in a low-lying dominant accessory renal artery. INDIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY 2020. [DOI: 10.4103/ijves.ijves_2_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Akingboye AA, Patel B, Cross FW. Femorofemoral Crossover Bypass Graft Has Excellent Patency When Performed with EVAR for AAA with UIOD. South Med J 2018; 111:56-63. [PMID: 29298371 DOI: 10.14423/smj.0000000000000757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To compare the durability of the crossover femorofemoral bypass graft (CFFBG) in combination with aorto-uni-iliac stent graft (AUIS) for abdominal aortic aneurysm with the durability of CFFBG used in the treatment of unilateral iliac occlusive disease (UIOD). METHODS We analyzed the clinical records of 69 patients who underwent CFFBG from 1992 until 2010. Group I consisted of 34 patients who received CFFBGs in combination with AUIS. Group II consisted of 35 patients treated with CFFBG for UIOD. The mean period of follow up was 2.7 years. Outcomes analyzed included primary graft patency, secondary graft patency, and postoperative morbidity and mortality. RESULTS There was one death in each group. Wound infection complicated 11.4% of CFFBGs performed as a sole procedure for UIOD and 5.8% of cases in combination with AUIS (P = 0.673). Primary graft patency was 96.5% and 96.5% at 2 and 5 years in group I, compared with 76.6% and 53.7% in group II (P = 0.046, 0.009). Secondary graft patency at 5 years was 100% and 92.9% for groups I and II, respectively. No variables independently influenced primary graft patency. Patients in group I experienced complications that could be linked to the bypass graft in 20.5% of cases, after long-term follow-up. CONCLUSIONS The CFFBG possesses superior long-term durability and patency when implemented in combination with aorto-uni-iliac stent grafts and does not seem to compromise the endpoint success of endovascular treatment.
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Affiliation(s)
- Akinfemi A Akingboye
- From the Royal London Hospital and Barts Cancer Institute, Queen Mary University of London, London, and Department of General Surgery, Colchester Hospital University Foundation Trust, Essex, United Kingdom
| | - Bijendra Patel
- From the Royal London Hospital and Barts Cancer Institute, Queen Mary University of London, London, and Department of General Surgery, Colchester Hospital University Foundation Trust, Essex, United Kingdom
| | - Frank W Cross
- From the Royal London Hospital and Barts Cancer Institute, Queen Mary University of London, London, and Department of General Surgery, Colchester Hospital University Foundation Trust, Essex, United Kingdom
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Dortch JD, Oldenburg WA, Farres H, Rawal B, McKinney JM, Paz-Fumagalli R, Hakaim AG. Long-term Results of Aortouniiliac Stent Grafts for the Endovascular Repair of Abdominal Aortic Aneurysms. Ann Vasc Surg 2014; 28:1258-65. [DOI: 10.1016/j.avsg.2013.12.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 12/17/2013] [Accepted: 12/24/2013] [Indexed: 10/25/2022]
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Tsilimparis N, Lohrenz C, Pflugradt A, Wipper S, Debus S, Kölbel T. Back-table modification of a bifurcated infrarenal stent-graft to aortomonoiliac for emergencies. J Endovasc Ther 2014; 21:348-52. [PMID: 24754298 DOI: 10.1583/13-4567r.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To describe a simple and quick technique for converting a Zenith bifurcated stent-graft to an aortouni-iliac device for emergency treatment of hemorrhage when a suitable marketed stent-graft is not readily available. TECHNIQUE The technique is described in an emergent case involving a 72-year-old man presenting with an aortoduodenal fistula and acute gastrointestinal bleeding. The Zenith device was prepared and flushed in the typical fashion. An extra stiff Lunderquist wire was advanced through the graft for better stability during the modification. The peel-away sheath was advanced beyond the hemostatic valve to allow partial release of the graft from the back then the grey positioner was retracted while the sheath was held firmly on the table, partially deploying the iliac limbs from the back side of the sheath. An occluding non-absorbable braided suture was placed at the short limb of the bifurcated graft close to the middle of the contralateral limb stent, through the webbing connecting both limbs below the flow divider of the bifurcated Zenith device. The graft was then resheathed using manual pinching of the graft or compression with umbilical tape. In the illustrated case, the stent-graft was intentionally deployed with the uncovered stents below the renal arteries to facilitate easier explantation later on. CONCLUSION Back-table modification of stent-grafts is feasible in emergencies for operators familiar with all technical aspects and potential risks of the modifications.
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Tang T, Sadat U, Walsh S, Hayes PD. Comparison of the Endurant Bifurcated Endograft vs. Aortouni-iliac Stent-Grafting in Patients With Abdominal Aortic Aneurysms: Experience From the ENGAGE Registry. J Endovasc Ther 2013; 20:172-81. [DOI: 10.1583/1545-1550-20.2.172] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Melas N, Saratzis A, Dixon H, Saratzis N, Lazaridis J, Perdikides T, Kiskinis D. Isolated Common Iliac Artery Aneurysms:A Revised Classification to Assist Endovascular Repair. J Endovasc Ther 2011; 18:697-715. [PMID: 21992642 DOI: 10.1583/11-3519.1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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De Rango P, Estrera AL, Azizzadeh A, Safi HJ. Stent-Graft Repair of Aortobronchial Fistula: A Review. J Endovasc Ther 2009; 16:721-32. [DOI: 10.1583/09-2800.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Endovascular Abdominal Aortic Aneurysm Repair: Part I. Ann Vasc Surg 2009; 23:799-812. [DOI: 10.1016/j.avsg.2009.03.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Accepted: 03/21/2009] [Indexed: 12/20/2022]
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Jean-Baptiste E, Batt M, Azzaoui R, Koussa M, Hassen-Khodja R, Haulon S. A Comparison of the Mid-term Results Following the use of Bifurcated and Aorto-uni-iliac Devices in the Treatment of Abdominal Aortic Aneurysms. Eur J Vasc Endovasc Surg 2009; 38:298-304. [DOI: 10.1016/j.ejvs.2009.06.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2008] [Accepted: 06/06/2009] [Indexed: 10/20/2022]
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Lazaridis J, Melas N, Saratzis A, Saratzis N, Sarris K, Fasoulas K, Kiskinis D. Reporting mid- and long-term results of endovascular grafting for abdominal aortic aneurysms using the aortomonoiliac configuration. J Vasc Surg 2009; 50:8-14. [DOI: 10.1016/j.jvs.2008.12.054] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Revised: 12/11/2008] [Accepted: 12/19/2008] [Indexed: 11/16/2022]
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13
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The Association between Iliac Fixation and Proximal Stent-graft Migration during EVAR Follow-up: Mid-term Results of 154 Talent Devices. Eur J Vasc Endovasc Surg 2009; 37:681-7. [DOI: 10.1016/j.ejvs.2009.03.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2008] [Accepted: 03/01/2009] [Indexed: 11/17/2022]
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Mantelas M, Antonitsis P, Kaitzis D, Hatzibaloglou A, Moros I. Spontaneous isolated dissection of the abdominal aorta: single-center experience. Interact Cardiovasc Thorac Surg 2009; 8:398-401. [DOI: 10.1510/icvts.2008.198051] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Saratzis N, Saratzis A, Melas N, Ktenidis K, Kiskinis D. Aortoduodenal Fistulas After Endovascular Stent-Graft Repair of Abdominal Aortic Aneurysms:Single-Center Experience and Review of the Literature. J Endovasc Ther 2008; 15:441-8. [DOI: 10.1583/08-2377.1] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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16
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Saratzis N, Melas N, Saratzis A, Tsakiliotis S, Lazarides J, Ktenidis K, Kiskinis D. Midterm Results of a Modified Technique for Implanting Tube Grafts During Endovascular Abdominal Aortic Aneurysm Repair. J Endovasc Ther 2008; 15:433-40. [DOI: 10.1583/08-2411.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Saratzis N, Melas N, Saratzis A, Lazarides J, Ktenidis K, Tsakiliotis S, Kiskinis D. Anaconda Aortic Stent-Graft:Single-Center Experience of a New Commercially Available Device for Abdominal Aortic Aneurysms. J Endovasc Ther 2008; 15:33-41. [PMID: 18254677 DOI: 10.1583/07-2277.1] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Jean-Baptiste E, Hassen-Khodja R, Bouillanne PJ, Haudebourg P, Declemy S, Batt M. Endovascular Repair of Infrarenal Abdominal Aortic Aneurysms in High-Risk-Surgical Patients. Eur J Vasc Endovasc Surg 2007; 34:145-51. [PMID: 17482485 DOI: 10.1016/j.ejvs.2007.02.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2006] [Accepted: 02/24/2007] [Indexed: 11/23/2022]
Abstract
PURPOSE Following the publication of a prospective randomized trial (EVAR2) that questioned the benefit of endovascular repair of abdominal aortic aneurysms (AAA) for high-surgical-risk patients, we evaluated our own initial and long-term results with endovascular AAA repair for this patient population. MATERIAL AND METHODS Between January 2000 and December 2005, 115 patients with an AAA managed by an aortic endograft were entered in a registry. Data concerning diagnosis, operative risk, treatment, and follow-up were analyzed on an intention-to-treat basis for all patients considered to be poor candidates for surgery. Patients with a ruptured AAA and those who were good surgical candidates were excluded from analysis. The main goal was evaluation of the operative mortality and the long-term survival of these patients. Secondary goals were determination of the frequency of secondary operations, the outcome of the aneurysm sac, and primary and secondary patency rates after aortic endograft placement. RESULTS A total of 92 high-surgical-risk patients treated by an endograft were entered in this study. Sixty-seven patients (73%) were classed ASA III and 18 (20%) were ASA IV (20%). Mean aneurysm diameter was 58 mm+/-9 mm. The technical success rate was 99%. Operative mortality was 4.3% (4 cases). Four patients required re-intervention during the mean follow-up of 18 months. The survival rate at 3 yr was 85%. One type I endoleak (1%) and 9 type II endoleaks (9.7%) occurred during the follow-up period. Primary and secondary patency rates at 3 yr were respectively 96% and 100%. CONCLUSION Our initial and long-term results with endograft repair of AAA in high-surgical-risk patients were satisfactory. These results appear to justify endovascular repair for this patient population.
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Affiliation(s)
- E Jean-Baptiste
- Department of Vascular Surgery, University Hospital of Nice, Nice, France
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Dalainas I, Moros I, Gerasimidis T, Papadimitriou D, Saratzis N, Gitas CG, Kiskinis D, Lazaridis J. Mid-Term Comparison of Bifurcated Modular Endograft Versus Aorto-Uni-Iliac Endograft in Patients with Abdominal Aortic Aneurysm. Ann Vasc Surg 2007; 21:339-45. [PMID: 17484970 DOI: 10.1016/j.avsg.2006.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2005] [Revised: 06/07/2006] [Accepted: 06/09/2006] [Indexed: 10/21/2022]
Abstract
The aim of this prospective study was to compare the outcome of the Talent bifurcated endograft versus the Endofit aorto-uni-iliac endograft in the short-term and mid-term. Between March 2000 and December 2003, 86 patients were treated with the Talent bifurcated endograft (group A) and 21 with the Endofit aorto-uni-iliac endograft (group B) in the same institute by the same surgical team. All patients followed a prospective protocol of preoperative evaluation and postoperative follow-up. We compared groups A and B in terms of perioperative mortality and morbidity, mid-term endoleak rate, mid-term success rate, and mid-term survival. The perioperative mortality for group A was 1.63%, while that for group B was 0% (P = 0.62). The endoleak rate for group A was 4.65%, and that for group B was 14.29% (P = 0.135). The mid-term success rate was 96.5% for group A and 100% for group B (P = 0.386). There was no significant difference in outcome between the patients treated with the Talent and those treated with the Endofit endoprosthesis. Treating abdominal aortic aneurysms with aorto-uni-iliac endoprosthesis is as safe and effective as treating them with bifurcated endografts.
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Affiliation(s)
- Ilias Dalainas
- 1st Surgical Department, Aristotle University, Thessaloniky, Greece.
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Saratzis NA, Saratzis AN, Melas N, Ginis G, Lioupis A, Lykopoulos D, Lazaridis J, Dimitrios K. Endovascular Repair of Traumatic Rupture of the Thoracic Aorta: Single-Center Experience. Cardiovasc Intervent Radiol 2007; 30:370-5. [PMID: 17295078 DOI: 10.1007/s00270-006-0186-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Traumatic rupture of the thoracic aorta secondary to blunt chest trauma is a life-threatening emergency and a common cause of death, usually following violent collisions. The objective of this retrospective report was to evaluate the efficacy of endovascular treatment of thoracic aortic disruptions with a single commercially available stent-graft. METHODS Nine men (mean age 29.5 years) were admitted to our institution between January 2003 and January 2006 due to blunt aortic trauma following violent motor vehicle collisions. Plain chest radiography, spiral computed tomography, aortography, and transesophageal echocardiography were used for diagnostic purposes in all cases. All patients were diagnosed with contained extramural thoracic aortic hematomas, secondary to aortic disruption. One patient was also diagnosed with a traumatic thoracic aortic dissection, secondary to blunt trauma. All subjects were poor surgical candidates, due to major injuries such as multiple bone fractures, abdominal hematomas, and pulmonary contusions. All repairs were performed using the EndoFit (LeMaitre Vascular) stent-graft. RESULTS Complete exclusion of the traumatic aortic disruption and pseudoaneurysm was achieved and verified at intraoperative arteriography and on CT scans, within 10 days of the repair in all patients. In 1 case the deployment of a second cuff was necessary due to a secondary endoleak. In 2 cases the left subclavian artery was occluded to achieve adequate graft fixation. No procedure-related deaths have occurred and no cardiac or peripheral vascular complications were observed within the 12 months (range 8-16 months) follow-up. CONCLUSIONS This is the first time the EndoFit graft has been utilized in the treatment of thoracic aortic disruptions secondary to chest trauma. The repair of such pathologies is technically feasible and early follow-up results are promising.
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Affiliation(s)
- Nikolaos A Saratzis
- 1st Department of Surgery, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece.
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Saratzis N, Saratzis A, Melas N, Ginis G, Lioupis A, Lykopoulos D, Lazaridis J, Kiskinis D. Endovascular Treatment of Descending Thoracic Aortic Aneurysms with the EndoFit Stent-Graft. Cardiovasc Intervent Radiol 2007; 30:177-81. [PMID: 17206390 DOI: 10.1007/s00270-006-0168-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate the mid-term feasibility, efficacy, and durability of descending thoracic aortic aneurysm (DTAA) exclusion using the EndoFit device (LeMaitre Vascular). METHODS Twenty-three (23) men (mean age 66 years) with a DTAA were admitted to our department for endovascular repair (21 were ASA III+ and 2 refused open repair) from January 2003 to July 2005. RESULTS Complete aneurysm exclusion was feasible in all subjects (100% technical success). The median follow-up was 18 months (range 8-40 months). A single stent-graft was used in 6 cases. The deployment of a second stent-graft was required in the remaining 17 patients. All endografts were attached proximally, beyond the left subclavian artery, leaving the aortic arch branches intact. No procedure-related deaths have occurred. A distal type I endoleak was detected in 2 cases on the 1 month follow-up CT scan, and was repaired with reintervention and deployment of an extension graft. A nonfatal acute myocardial infarction occurred in 1 patient in the sixth postoperative month. Graft migration, graft infection, paraplegia, cerebral or distal embolization, renal impairment or any other major complications were not observed. CONCLUSION The treatment of DTAAs using the EndoFit stent-graft is technically feasible. Mid-term results in this series are promising.
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Affiliation(s)
- N Saratzis
- Department of Surgery, Aristotle University of Thessaloniki Papageorgiou General Hospital, Thessaloniki, Greece
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Saratzis N, Melas N, Saratzis A, Lioupis A, Lazaridis J, Ginis G, Ktenidis K, Kiskinis D. EndoFit Stent-Graft Repair of Isolated Common Iliac Artery Aneurysms With Short Necks. J Endovasc Ther 2006; 13:667-71. [PMID: 17042664 DOI: 10.1583/06-1858.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate the feasibility and efficacy of repairing isolated iliac artery aneurysms with short proximal necks (<10 mm) by implanting the EndoFit stent-graft. METHODS Seven patients (6 men; median age 73 years, range 70-78) were diagnosed with an isolated common iliac artery (CIA) aneurysm that featured a short proximal landing zone, complicating endovascular treatment. The median aneurysm diameter was 4.4 cm (range 3.5-7.0), and the median proximal neck length was 7 mm (range 5-9).The aneurysms were treated using the EndoFit stent-graft, which can be deployed in a short proximal landing zone. The modified technique involves the deployment of the graft directly above the aneurysm sac without obstructing the contralateral iliac axis, thus affixing the bare proximal stent in the terminal aorta. Follow-up was performed by clinical evaluation and computed tomography at 1, 6, and 12 months postoperatively. RESULTS The EndoFit stent-graft was successfully deployed in all cases, with complete aneurysm exclusion. In 1 case, the deployment of a second cuff was necessary to secure complete aneurysm exclusion. The median follow-up was 18 months, during which no deaths occurred, and no endoleak or stent-graft migration was observed. Endograft thrombosis occurred in 1 case due to graft angulation caused by external iliac artery stenosis and kinking. None of the aneurysms has ruptured, and there have been no serious complications. CONCLUSION Direct endoluminal repair of isolated CIA aneurysms with short proximal necks is feasible using this technique. Efficacy and long-term results are to be confirmed by larger scale series over a long time period.
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Affiliation(s)
- Nikolaos Saratzis
- First Department of Surgery, Aristotle University, Papageorgiou General Hospital, Thessaloniki, Greece
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Dalainas I, Nano G. Regarding "Endovascular AAA repair with the aortomonoiliac endofit stent-graft: two years' experience". J Endovasc Ther 2005; 12:755. [PMID: 16363907 DOI: 10.1583/05-1675r.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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