Stentgraft implantations in patients with angulated neck of AAA – procedure planning, outcomes and complications
Journal Title: Postępy Nauk Medycznych - Year 2012, Vol 25, Issue 5
Abstract
<b>Introduction.</b> It was noticed from the beginning of the use of stentgrafts for AAA treatment, that aneurysms’ neck is the main risk factor for unsuccessful procedure (endoleaks), especially when too broad, too short, calcified, with extensive trombi or finally significantly angulated.<br><b>Material and methods. </b>In the years 2006-2011, 405 EVAR procedures were performer, including 92 patients (23%), in whom aortic neck angulation u > 60°<sup> </sup>was found. All treated AAAs were > 50 mm in diameter (mean 59 mm). Diameter of aortic neck was from 23 to 30 mm (mean 27 mm), and its length was from 10 to 45 mm (mean 23 mm). According to neck angulation patients were divided into two groups: with lower grade angulation (60-80°) and with higher grade angulation (> 80°). We used three different types of stentgrfats: Aorfix, Excluder and Zenith.<br><b>Results.</b> In all 92 patients stentgraft implantations were as planned. There were no surgical conversions. In peri operational period (30 days) reinterventions were needed in 2 patients, we successfully treated endovascularly kinkings of aortic arm and iliac arm respectively. In a long-term (12 and 24 months) follow-up there were no deaths due to AAA rupture but type I endoleaks were noticed in 3 patients.<br><b>Conclusions.</b> AAA neck angulation > 60° is not a contraindication in qualifying patients for endovascular stentgrafting procedures. Proper selection of stentgraft type and size allows to obtain similar technical and clinical results when compared with straight neck AAAs.
Authors and Affiliations
Tomasz Jargiełło, Michał Sojka, Andrzej Wolski, Radosław Krupiński, Paweł Poluha, Małgorzata Szczerbo-Trojanowska
Keywords
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