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Intraoperative proximal endoleaks during AAA stent-graft repair: evaluation of risk factors and treatment with Palmaz stents.

AbstractPURPOSE:
To study factors that might contribute to intraoperative proximal type I endoleak and to evaluate the placement of giant Palmaz stents as a therapeutic option.
METHODS:
Thirty-three patients (30 men; median age 72 years, range 50-85) with abdominal aortic aneurysms underwent implantation of fully supported Gianturco Z-stent-based endografts (12 custom-made aortomonoiliac and 21 bifurcated Zenith devices). Ten (30%) patients were treated for intraoperative proximal endoleaks. Stent-graft oversizing and neck angulation, length, and shape were compared between patients with and without leaks.
RESULTS:
In 9 cases, the endoleaks were successfully treated with intraoperative placement of Palmaz stents without complications. In 1 patient, a leak that was resolved intraoperatively with balloon dilation reappeared 1 month later; a Palmaz stent was deployed successfully. Stent-graft oversizing did not differ significantly between patients who developed proximal endoleaks and those who did not (median 4.0 mm in both groups, p = 0.47). Median neck length was 21.0 mm in patients with endoleak and 28.0 mm in those without (p > 0.99). Median neck angulation was 30 degrees in both groups (p = 0.33), and the presence of a conical aneurysm neck was not significantly different (2/10 versus 6/23, p > 0.99). All aneurysms remained excluded at a median follow-up of 13 months (range 6-24).
CONCLUSIONS:
Stent-graft oversizing and neck morphology (length, angulation, and conical shape) do not seem to correlate with the incidence of proximal type I endoleaks. Palmaz stent placement appears to be a feasible and safe treatment option for this complication.
AuthorsN V Dias, T Resch, M Malina, B Lindblad, K Ivancev
JournalJournal of endovascular therapy : an official journal of the International Society of Endovascular Specialists (J Endovasc Ther) Vol. 8 Issue 3 Pg. 268-73 (Jun 2001) ISSN: 1526-6028 [Print] United States
PMID11491261 (Publication Type: Comparative Study, Evaluation Study, Journal Article)
Topics
  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm, Abdominal (complications, therapy)
  • Catheterization (instrumentation)
  • Female
  • Follow-Up Studies
  • Humans
  • Intraoperative Complications (etiology)
  • Male
  • Middle Aged
  • Risk Factors
  • Stents
  • Treatment Outcome
  • Vascular Surgical Procedures (instrumentation)

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