Outcome of Tubular Aortoaortic Endografts in Infrarenal Aneurysmal Disease and Penetrating Abdominal Aortic Ulcers-a Long-Term Follow-up.

Engelberger, Stephan; Prouse, Giorgio; Riva, Francesca; Van den Berg, Josua Cornelis; Giovannacci, Luca (2020). Outcome of Tubular Aortoaortic Endografts in Infrarenal Aneurysmal Disease and Penetrating Abdominal Aortic Ulcers-a Long-Term Follow-up. Annals of vascular surgery, 62, pp. 206-212. Elsevier 10.1016/j.avsg.2019.06.032

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BACKGROUND

We describe the long-term follow-up of patients treated for infrarenal abdominal aortic aneurysms and penetrating ulcers by placement of tubular aortic endografts at our institution from 2010 to present.

METHODS

This is a retrospective study using clinical data of patients treated from 2010 to present by placement of either a single aortic tubular endograft or by two overlapping endografts, using the "trombone technique." Aortic dimensions were measured from the preoperative computed tomography scans using three-dimensional reconstruction. The primary outcome was aortic reintervention. Secondary outcomes were aorta-related mortality, endoleaks, and postoperative complications.

RESULTS

Twenty-eight patients were identified. Nine patients were treated for saccular aneurysms, and nineteen patients presented with penetrating aortic ulcers. The median follow-up was 31 months (range: 4-99). Twenty patients were treated with a single tubular device, while eight patients were treated using two overlapping devices. Aortic reintervention occurred in four patients (14.3%), all were treated initially with a single device. No aortic mortality occurred during follow-up. No aneurysm ruptures occurred. Four patients died during follow-up of unrelated causes. Endoleaks occurred in ten patients (35%). Five endoleaks were of type I (17.8%), of which three were of distal type (10.7%). Five endoleaks were of type II (17.8%). Shorter distal landing zones than 20 mm were present in two of the cases with a distal type I endoleak (P = 0.0232). Postoperative complications occurred in three (10.7%) patients including one myocardial infarction and two wound complications from a surgical cut down in the groin.

CONCLUSIONS

The technique shows an acceptable postoperative complication rate but is characterized by high rate of occurrence of type I endoleaks and aortic reintervention in our series. Endovascular techniques using tubular endografts should be limited to cases with long proximal and distal sealing zones. The trombone technique seems preferable.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Van den Berg, Josua Cornelis

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1615-5947

Publisher:

Elsevier

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

16 Jan 2020 14:25

Last Modified:

05 Dec 2022 15:34

Publisher DOI:

10.1016/j.avsg.2019.06.032

Related URLs:

PubMed ID:

31449938

BORIS DOI:

10.7892/boris.137619

URI:

https://boris.unibe.ch/id/eprint/137619

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