Straight aortic endograft in abdominal aortic disease

Journal of Cardiothoracic Surgery

Giovanni Nano¹  Domenico G Tealdi¹  Stefano Manfrini²  Andrea Raspadori²  Silvia Stegher¹  Giovanni Malacrida¹  Maria Teresa Occhiuto¹  Daniela Mazzaccaro¹ 

[1] First Unit of Vascular Surgery, IRCCS Policlinico San Donato, University of Milan, piazza E. Malan 1, San Donato Milanese, Milan 20097, Italy;Department of Vascular Surgery, Casa di Cura Salus, Ferrara, Italy

关键词: AAA;    Straight endograft;    EVAR;   

Others  :  825513
DOI  :  10.1186/1749-8090-8-114

 received in 2012-08-16, accepted in 2013-04-12,  发布年份 2013

【 摘 要 】

Background

We describe our 8-year experience with the use of endovascular techniques (ET) for the treatment of abdominal aortic aneurysms (AAA) through a straight endograft.

Methods

We retrospectively reviewed data of all patients who were treated for AAA using ET in two centres from 1998 to 2012 and who received a single straight endograft (group A) or a double straight tube (group B). Outcomes were analyzed to assess survival, absence of endoleak and absence of reintervention for both groups. Log-rank and Chi-Square were used as appropriate to make comparison between the two groups. P values < .05 were considered statistically significant.

Results

Fifty-three patients from 1998 to May 2012 were treated for AAA using a straight endograft. In 28 cases (52.8%) a single aortic straight tube was used (Group A), while in the remaining cases a “double trombone technique” was used (Group B).

Primary success was obtained in 52 cases (98.1%). In one patient of group A immediately after the operation we observed a type Ia endoleak, which was correct with a proximal aortic cuff.

Fluoroscopy time, operation time, amount of intraprocedural contrast medium and blood loss were slightly higher for group B, even if not significantly. Mortality at 30 days was nil for both groups. Mean follow-up was 49 months (range 2–153 months).

Five patients died in group A, four of them for a neoplastic disease and the remaining for aortic rupture. No patients died in group B. Endoleaks occurred more frequently in patients of group A (5 type I endoleaks and 1 type II endoleak from a lumbar artery).

Reintervention were more frequent for patients of group A, being type I endoleak the main cause. A stent fracture was observed in a patient who received EVAR by “trombone technique” 3 months later. Reintervention was then necessary and a third stent was successfully placed to cover the lesion.

Conclusions

In our experience the endovascular repair of AAA using straight aortic endografts was a safe and effective technique. Reintervention and endoleaks were slightly more frequent in patients who had received a single endograft compared to patients who were treated using the “trombone technique”.

【 授权许可】

   
2013 Mazzaccaro et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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