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Single center experience of endovascular abdominal aortic aneurysms repair
Journal of Cardiothoracic Surgery volume 8, Article number: O7 (2013)
To present own results of endovascular repair of abdominal aortic aneurysms (EVAR AAA) using different techniques in patients with challenging anatomy and a wide range of different comorbidities being therefore unfit for open surgery due to high perioperative risk value.
Since May 2010 51 patients with a median age of 69 years were included. Among them there were 32 (89%) men and 4 (11%) women. 28 (78%) patients had infrarenal localization of abdominal aortic aneurysms, 8 (22%) patients had juxtarenal localization of AAA. In 34 patients (94%) abdominal aortic aneurysms were etiologicaly atherosclerotic and in 2 patients (6%) it was Marfan syndrome to be the definite reason for aneurysmatic disease.
The maximum dimensions of the abdominal aorta averaged 59 ± 18mm. All patients had challenging anatomy: short and severely angulated and/or conic proximal aortic neck, unsuitable distal ”landing zone”, thrombus, calcification and complicated morphology, complex aneurysms and dissections of iliac and femoral arteries.
All patients got epidural/spinal anesthesia. 4 patients with juxtrarenal AAA were operated on with fenestrated endoprostheses and in 4 patients- “chimney” technique was used (including 1 patient with “sandwich” technique). In cases of complicated morphology of iliac arteries subclavian/axillary access was used. Also we made femoro-femoral or femoro-popliteal bypass in 3 patients with need of lower extremities revascularizaton. Still 2 patients revealed acute in-stent thrombosis due to dissection of distal part of external iliac artery and due to crushed chimney-stent successfully managed with balloon angioplasty and supplementary stent implantation. Hospital mortality was 2,8% (1 patient died due to acute MI on 5 day after procedure). 30-day’s mortality was 2,8% as well.
EVAR is the promising alternative to conventional open aortic repair.
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Akchurin, R., Imaev, T., Lepilin, P. et al. Single center experience of endovascular abdominal aortic aneurysms repair. J Cardiothorac Surg 8, O7 (2013). https://doi.org/10.1186/1749-8090-8-S1-O7
- Iliac Artery
- Abdominal Aortic Aneurysm
- Marfan Syndrome
- Endovascular Repair
- External Iliac Artery