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Endovascular treatment of late complications of open surgical repair in abdominal aortic and iliac segment
Affiliations- Clinic of Vascular Surgery, Institute of Haematology and Transfusion Medicine, Warsaw, Poland, ul. Indury Gandhi 14, 02-776 Warsaw, Poland
- 2. 1st Chair and Clinic of General and Vascular Surgery 2nd Faculty of Medicine Medical University of Warsaw, Kondratowicza 8, 03-242 Warsaw, Poland
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Abstract
Introduction. Promising results of endovascular abdominal aortic aneurysm treatment prompts one to
consider applying the method in order to manage complications following the previous open procedures in the
aorto-iliac segment. The study aimed at assessing the technical feasibility of applying endovascular methods
to manage complications in this group.
Material and methods. From December 2009 to August 2018, 26 patients (24 males, 2 females) with
a mean age of 72 years, underwent endovascular procedures as reinterventions to manage paraanastomotic
aneurysms and new true aneurysms in aorto-iliac segment. Twenty one bifurcated, two branched devices and
five tube stent-grafts have been implanted.
Results. One immediate open conversion was performed. Eventually, in all of the analysed cases, perianastomotic
pseudoaneurysms and true aneurysms were successfully managed. Two cases of type I endoleaks were
noticed and managed intraoperatively. No deaths occurred in the perioperative period. In six patients, there
were early local complications and early general complications were reported in eight patients. The average
length of hospital stay was seven days. Patients have been followed up for 6 to 90 months. No endoleaks nor
stent-graft migrations have been reported. Five deaths have been noted not connected with the secondary
intervention. Sixteen patients remain in follow-up.
Conclusions. Endovascular perianastomotic aneurysm treatment is technically feasible and associated with
a low risk of perioperative complications, and a high surgical efficacy. When planning the reintervention, one
should take into account the altered anatomy of the aorto-iliac segment. Familiarity with the equipment and
experience in the endovascular techniques is of crucial significance.
Abstract
Introduction. Promising results of endovascular abdominal aortic aneurysm treatment prompts one to
consider applying the method in order to manage complications following the previous open procedures in the
aorto-iliac segment. The study aimed at assessing the technical feasibility of applying endovascular methods
to manage complications in this group.
Material and methods. From December 2009 to August 2018, 26 patients (24 males, 2 females) with
a mean age of 72 years, underwent endovascular procedures as reinterventions to manage paraanastomotic
aneurysms and new true aneurysms in aorto-iliac segment. Twenty one bifurcated, two branched devices and
five tube stent-grafts have been implanted.
Results. One immediate open conversion was performed. Eventually, in all of the analysed cases, perianastomotic
pseudoaneurysms and true aneurysms were successfully managed. Two cases of type I endoleaks were
noticed and managed intraoperatively. No deaths occurred in the perioperative period. In six patients, there
were early local complications and early general complications were reported in eight patients. The average
length of hospital stay was seven days. Patients have been followed up for 6 to 90 months. No endoleaks nor
stent-graft migrations have been reported. Five deaths have been noted not connected with the secondary
intervention. Sixteen patients remain in follow-up.
Conclusions. Endovascular perianastomotic aneurysm treatment is technically feasible and associated with
a low risk of perioperative complications, and a high surgical efficacy. When planning the reintervention, one
should take into account the altered anatomy of the aorto-iliac segment. Familiarity with the equipment and
experience in the endovascular techniques is of crucial significance.
Keywords
complications, endovascular treatment, stent-graft
About this articleTitle
Endovascular treatment of late complications of open surgical repair in abdominal aortic and iliac segment
Journal
Issue
Article type
Research paper
Pages
123-133
Published online
2018-12-30
Page views
714
Article views/downloads
954
DOI
Bibliographic record
Acta Angiologica 2018;24(4):123-133.
Keywords
complications
endovascular treatment
stent-graft
Authors
Piotr Szopiński
Eliza Pleban
Maciej Stryga
Piotr Ciostek
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