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Titolo:
Incidence and treatment of intraoperative technical problems during endovascular repair of complex abdominal aortic aneurysms
Autore:
Kalliafas, S; Albertini, JN; Macierewicz, J; Yusuf, SW; Whitaker, SC; MacSweeney, ST; Wenham, PW; Hopkinson, BR;
Indirizzi:
Univ Nottingham Hosp, Div Vasc Surg, Nottingham, England Univ Nottingham Hosp Nottingham England Vasc Surg, Nottingham, England
Titolo Testata:
JOURNAL OF VASCULAR SURGERY
fascicolo: 6, volume: 31, anno: 2000,
pagine: 1185 - 1192
SICI:
0741-5214(200006)31:6<1185:IATOIT>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
STENT-GRAFTS; FEMOROFEMORAL BYPASS; EXPERIENCE; SURGERY; COMPLICATIONS; INTERVENTION; EMBOLIZATION; TRIAL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Kalliafas, S Queens Med Ctr, Div Vasc Surg, Floor E West Block, NottinghamNG7 2UH, England Queens Med Ctr Floor E West Block Nottingham England NG72UH
Citazione:
S. Kalliafas et al., "Incidence and treatment of intraoperative technical problems during endovascular repair of complex abdominal aortic aneurysms", J VASC SURG, 31(6), 2000, pp. 1185-1192

Abstract

Purpose: The purpose of this study was to assess the incidence and management of intraoperative technical problems during endovascular repair (EVR) of complex abdominal aortic aneurysms (AAA). Methods: From February 1995 to March 1999, 204 EVRs of nonruptured AAA were performed at our institution. One hundred seventy-six patients had an in-house custom-made graft; 172 were aorto-uni-iliac grafts, and four were aortoaortic grafts. Twenty-eight patients had a bifurcated graft. One hundred fourteen patients (56%) were high risk for conventional open repair. One hundred nine patients (53%) were not suitable for most commercially availabledevices. Results: Intraoperative technical problems occurred in 81 patients (40%). There were 37 endoleaks (27 proximal, 10 distal), 15 graft stenoses, one failure of graft deployment, two graft thromboses, three aortoiliac ruptures,five renal artery occlusions (one bilateral, four unilateral), and 18 internal iliac occlusions (five bilateral, 13 unilateral). Endovascular management of these problems was successful in 37 of the 81 patients (46%) and included 15 balloon dilatations, 21 additional stent placements, and one graftthrombectomy. Fifteen of the 81 patients (19%) had open procedures (four periaortic ligature placements, six open aneurysm repairs, three common iliac ligations, and two extra-anatomic bypass grafts). In the remaining 29 patients, the on-table problem was managed expectantly. During follow-up, two of 37 patients (5%) who were treated successfully with endovascular procedures experienced recurrence. There were five deaths (33%) among the 15 patients who underwent open procedures. Conclusion: Intraoperative problems occur frequently during the endovascular management of complex aneurysms. Many of these problems can be managed with additional endovascular techniques without an increased risk of recurrence or procedure-related complications. Open procedures in high-risk patients carry a high mortality rate. The team performing EVR of AAA should be skillful in advanced endovascular and open surgical procedures.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/11/20 alle ore 09:05:14