医学
外科
腔内修复术
放射科
腹主动脉瘤
血管内治疗
主动脉瘤
动脉瘤
腹部外科
支架
作者
Pietro Volpe,Antonino Alberti,Mafalda Massara
标识
DOI:10.1016/j.avsg.2020.04.003
摘要
Background Juxtarenal abdominal aortic aneurysms represent 15–20% of all abdominal aortic aneurysms (AAAs). The gold standard of treatment is represented by open surgical repair (OSR). Patients judged unfit for OSR could be submitted to fenestrated endovascular aortic repair (FEVAR) or the chimney technique. FEVAR requires 3–4 weeks for endograft production, a minimal length of 4 mm for proximal aortic neck and a large access vessels diameter, with high costs. The traditional chimney technique, feasible also in urgent cases, has a risk of type IA endoleak due to the space created between covered stents introduced into visceral arteries and the endograft. Methods In the present article, we report our experience about juxtarenal AAA (jAAA) treatment in 5 patients, recurring to uncovered bare metal stents associated with the ultralow profile Ovation endograft. Results No intraoperative complications or type IA endoleaks were recorded. Primary clinical success at 1 month was also 100%. During a mean follow-up period of 12.1 ± 3.6 months (range, 9–15 months), no complications related to aneurysm were recorded. Conclusions The technique reported represents a valid endovascular option for jAAA treatment in patients at high risk for OSR. With respect to FEVAR, urgent patients should also be treated. With respect to traditional Ch-EVAR, the risk of type IA endoleak is reduced, with a lower rate of reoperation during follow-up. Preliminary clinical results are promising.
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