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Clinical Efficacy of Endovascular Abdominal Aortic Aneurysm Repair

  • Son, Bong-Su (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Pusan National University) ;
  • Chung, Sung-Woon (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Pusan National University) ;
  • Lee, Chung-Won (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Pusan National University) ;
  • Ahn, Hyo-Yeong (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Pusan National University) ;
  • Kim, Sang-Pil (Department of Thoracic and Cardiovascular Surgery, School of Medicine, Pusan National University) ;
  • Kim, Chang-Won (Department of Radiology, School of Medicine, Pusan National University)
  • Received : 2010.10.05
  • Accepted : 2011.02.09
  • Published : 2011.04.05

Abstract

Background: Endovascular aortic aneurysm repair (EVAR) has come into use and been widely extended because of the low complication rate and less-invasiveness. This article aimed to describe our experience in the treatment of abdominal aortic aneurysm with EVAR. Materials and Methods: A retrospective review was conducted for the 22 patients who underwent EVAR in a single hospital December 2001 to June 2009. Results: The mean age of the patients was $68.5{\pm}7.6$ years. There were several risk factors and comorbidities in 20 patients (90.9%). The mean diameter of the aortic aneurysms was $61.2{\pm}12.9$ mm. The mean length, diameter, and angle of the aneurysmal neck were $30.5{\pm}15.5$ mm, $24.0{\pm}4.5$ mm, and $43.9{\pm}16.0^{\circ}$, respectively. The mean follow-up period of the patients was $28.8{\pm}29.5$ months. The 30-day postoperative mortality was none. Seven patients (31.8%) had endoleaks during the hospital stay and three patients (13.6%) had endoleaks during the follow-up period. One patient (4.5%) died due to a ruptured aortic aneurysm. The cumulative patient survival rates were 88.2%, 88.2%, and 70.6% at 1, 3, and 5 years of follow-up, respectively. Conclusion: EVAR is currently a safe, feasible procedure for high risk patients with abdominal aortic aneurysm because of low postoperative complication and mortality if patients are selected properly and followed up carefully.

Keywords

References

  1. Dubost C, Allary M, Oeconomos N. Resection of an aneurysm of the abdominal aorta: reestablishment of the continuity by a preserved human arterial graft, with results after five months. Arch Surg 1952;64:405-8. https://doi.org/10.1001/archsurg.1952.01260010419018
  2. Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vasc Surg 1991;5:491-9. https://doi.org/10.1007/BF02015271
  3. Shi DB, Fu WG, Wang YQ, et al. Short to midterm results of endovascular for 105 case of infrarenal abdominal aortic aneurysms. Zhonghua Wai Ke Za Zhi 2008;46:1638-41.
  4. Brewster DC, Jones JE, Chung TK, et al. Long-term outcomes after endovascular abdominal aortic aneurysm repair: the first decade. Ann Surg 2006;244:426-38.
  5. Hovsepian DM, Hein AN, Pilgram TK, et al. Endovascular abdominal aortic aneurysm repair in 144 patients: correlation of aneurysm size, proximal aortic neck length, and procedure- related complications. J Vasc Interv Radiol 2001;12:1373-82. https://doi.org/10.1016/S1051-0443(07)61692-3
  6. Ahn SS, Rutherford RB, Johnston KW, et al. Reporting standards for infrarenal endovascular abdominal aortic aneurysm repair. J Vasc Surg 1997;25:405-10. https://doi.org/10.1016/S0741-5214(97)70363-X
  7. Kim YW. Report of nation-wide Questionnaire survey for abdominal aortic aneurysm treatment in Korea. Korean J Vasc Surg 2005;21:10-5.
  8. Baum RA, Stavropoulos SW, Fairman RM, Carpenter JP. Endoleaks after endovascular repair of abdominal aortic aneurysms. J Vasc Interv Radiol 2003;14:1111-7. https://doi.org/10.1097/01.RVI.0000085773.71254.86
  9. Sampaio SM, Shin SH, Panneton JM, Andrews JC, Bower TC, Cherry KJ. Intraoperative endoleak during EVAR: frequency, nature, and significance. Vasc Endovascular Surg 2009;43:352-9. https://doi.org/10.1177/1538574409333581
  10. Pepplenbosch N, Buth J, Harris PL, Van Marresijk C, Fransen G. EUROSTAR Collaborators. Diameter of abdominal aortic aneurysm and outcome of endovascular aneurysm repair: does size matter? A report from EUROSTAR. J Vasc Surg 2004;39:288-97. https://doi.org/10.1016/j.jvs.2003.09.047
  11. Harris PL, Vallabhaneni SR, Desgranges P, Becquemin JP, Van Marrewijk C, Laheij RJ. Incidence and risk factors of late rupture, conversion, and death after endovascular repair of infrarenal aortic aneurysms: the EUROSTAR experience. European Collaborators on Stent/graft techniques for aortic aneurysm repair. J Vasc Surg 2000;32:739-49. https://doi.org/10.1067/mva.2000.109990
  12. May J, White GH, Yu W, et al. Endovascular grafting for abdominal aortic aneurysms: changing incidence and indication for conversion to open operation. Cardiovasc Surg 1998;6:194-7. https://doi.org/10.1016/S0967-2109(97)00132-4
  13. Matsumura JS, Brewster DC, Makaroun MS, Naftel DC. A multicenter controlled clinical trial of open versus endovascular treatment of abdominal aortic aneurysm. J Vasc Surg 2003;37:262-71. https://doi.org/10.1067/mva.2003.120
  14. Greenberg RK, Lawrence-Brown M, Bhandari G, et al. An update of the Zenith endovascular graft for abdominal aortic aneurysms: initial implantation and mid-term follow-up data. J Vasc Surg 2001;33:S157-64. https://doi.org/10.1067/mva.2001.111683
  15. Becquemin JP. The ACE trial: A randomized comparison of open versus endovascular repair in good risk patients with abdominal aortic aneurysm. J Vsc Surg 2009;50:222-4. https://doi.org/10.1016/j.jvs.2009.04.074

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