Double fixation for abdominal aortic aneurysm repair using AFX body and Endurant proximal aortic cuff: mid-term results.

Matsagkas, Miltiadis I; Kouvelos, George; Spanos, Konstantinos; Athanasoulas, Athanasios; Giannoukas, Athanasios

Matsagkas, Miltiadis I; Kouvelos, George; Spanos, Konstantinos; Athanasoulas, Athanasios; Giannoukas, Athanasios.

Afiliación

Matsagkas MI; Department of Vascular Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
Kouvelos G; Vascular Surgery Unit, Department of Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Spanos K; Department of Vascular Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
Athanasoulas A; Vascular Surgery Unit, Department of Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Giannoukas A; Department of Vascular Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.

Interact Cardiovasc Thorac Surg ; 25(1): 1-5, 2017 07 01.

Article en En | MEDLINE | ID: mdl-28431107

RESUMEN

Our goal was to evaluate the use of an AFX main body combined with an Endurant proximal aortic cuff to treat selected patients with an abdominal aortic aneurysm (AAA) associated with anatomical challenges, such as a small distal aortic diameter and a hostile aortic neck. A retrospective analysis of prospectively collected data from 2 vascular institutions identified 14 elective patients with an AAA (all men, 73.5 ± 5.1 years) treated with the AFX main body combined with an Endurant proximal aortic cuff. Patients had a small distal aortic diameter (median 19 mm) and a short or angulated proximal aortic neck (median length 20 mm, range 9-26 mm, median angulation 41.5°, range 23-80°). Six patients (42.9%) had an aortic neck that did not meet the indications for use of the AFX proximal aortic cuff. Primary technical success was achieved in all patients with no 30-day device-related complications or deaths. During a median follow-up period of 13 months (range 6-28 months), no re-intervention was needed. The diameter of the aneurysmal sac decreased from 57.6 ± 5.6 mm preoperatively to 50.4 ± 4.9 mm (P < 0.001) postoperatively. There were no aneurysm-related deaths or ruptures. No migration, disconnection or type I or III endoleak was observed. In 5 of the 6 patients, the initial type II endoleak spontaneously resolved during follow-up, whereas that in the remaining patient persisted without any change in the diameter of the aneurysmal sac. In patients with complex AAA anatomical configurations combining a hostile aortic neck and a narrow aortic bifurcation, the use of an AFX main body combined with an Endurant proximal aortic cuff seems to be feasible with favourable mid-term results.

Asunto(s)

Aneurisma de la Aorta Abdominal/cirugía; Prótesis Vascular; Procedimientos Endovasculares/métodos; Stents; Técnicas de Sutura/instrumentación; Anciano; Aneurisma de la Aorta Abdominal/diagnóstico; Aortografía/métodos; Femenino; Estudios de Seguimiento; Humanos; Masculino; Diseño de Prótesis; Estudios Retrospectivos; Factores de Tiempo; Tomografía Computarizada por Rayos X; Resultado del Tratamiento

Palabras clave

AFX; Abdominal aneurysm; EVAR; Endograft; Endurant

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Prótesis Vascular / Stents / Técnicas de Sutura / Aneurisma de la Aorta Abdominal / Procedimientos Endovasculares Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Interact Cardiovasc Thorac Surg Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Grecia Pais de publicación: Reino Unido

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