Endovascular stent-graft procedures in aorto-iliac pathologies: a single center experience

Background

We present our early results of endovascular treatments for the pathologies involving aorta and iliac arteries.

Methods

117 endovascular stent-graft procedures in 113 patients for thoracic, abdominal and iliac pathologies was performed at our institute between January 2009-April 2013. 94(83.1%) patients were male. Indications for endovascular interventions were as follows; 58 for abdominal aortic aneursym, 14 for descending aortic aneursym, 4 for both descending and abdominal aortic aneursyms, 2 for thoraco-abdominal aneurysm including visceral arteries, 22 for aortic dissection, 2 for penetrating ulcer, 6 for traumatic aortic rupture, 1 for intramural hematoma, 1 for bronchial artery aneurysm and 3 for common iliac artery aneursym. Chimney and periscope techniques were used in 2 patients and iliac-branched endograft was placed in 2 patients.

Results

25 of the 113 cases were treated emergently while the rest were elective procedures. Postoperative 30-day mortality was 6.19% (n=7). 5 of them had acute aortic pathologies (3 contained rupture,1 traumatic aortic rupture, 1 acute type-B dissection). The rest 2 patients died on the follow up period. Paraplegy occurred only in one patient(0.88%). Early endoleak rate was 21.2%, whereas late endoleak rate was 5.3%. 5 patients(4.2%) needed a second intervention. Visceral artery thrombosis was experienced in one patient during thoraco-abdominal aneurysm treatment with chimney technique,so the procedure was to be interrupted leaving abdominal aorta repair to a second stage.The overall technical success was 99.1%.Conversion to open surgery was not required in any patient.

Conclusion

Endovascular aortic repair is an encouraging technique with low morbidity and mortality rates even in the emergency cases. Our early results of endovascular interventions correlate with the literature data.