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Fenestrated and Branched Grafts for Para-Anastomotic Aortic Aneurysm Repair

2007; SAGE Publishing; Volume: 14; Issue: 4 Linguagem: Inglês

10.1177/152660280701400412

1545-1550

Peter Ziegler, Theodossios Perdikides, Efthymios D. Avgerinos, Thomas Umscheid, W. J. Stelter,

Infectious Aortic and Vascular Conditions

To investigate the use of fenestration and branch artery stenting during endovascular stent-graft repair of para-anastomotic aneurysms (PAA).A retrospective review was conducted of 9 patients (all men; mean age 71 years, range 60-80) who received custom-designed fenestrated endoprostheses for PAA repair. Eight tubular fenestrated devices and 1 composite device (fenestrated tube plus modular bifurcated body) with a total of 31 fenestrations were used.The mean operating time was 318+/-93 minutes (range 220-485); the mean fluoroscopy time was 77+/-38 minutes (range 39-158), during which a mean 121+/-81 mL (range 33-300) of contrast was used. Technical success was achieved in all cases. Over a mean follow-up of 12+/-5.5 months (range 6-24), 1 secondary intervention was carried out due to a break in a side branch stent-graft; 2 transient renal impairments and 1 permanent renal insufficiency unrelated to renal artery patency were observed. So far, no vessel loss has emerged.Conventional repair of PAA has been a standard procedure for many years, though it carries high surgical risk as well as perioperative mortality. Fenestrated endografts may be a promising alternative in selected patients.