Abstract:
PURPOSE:To assess the feasibility and effectiveness of emergency endovascular treatment of abdominal aortic aneurysms (AAAs). METHODS:During 36 months we treated, on an emergency basis, 30 AAAs with endovascular exclusion. In 21 hemodynamically stable patients preoperative CT angiography (CTA) was performed to confirm the diagnosis and to plan the treatment; 9 patients with hemorrhagic shock were evaluated with angiography performed in the operating room. Twenty-two Excluder (Gore) and 8 Zenith (Cook) stent-grafts (25 bifurcated and 5 aorto-uni-iliac) were used. The follow-up was performed by CTA at 1, 3, 6, and 12 months. RESULTS:Technical success was achieved in 100% of cases with a 10% mortality rate. The total complication rate was 23% (5 increases in serum creatinine level and 2 wound infections). During the follow-up, performed in 27 patients (1-36 months, mean 15.2 months), 4 secondary endoleaks (15%) (3 type II, 2 spontaneously thrombosed and 1 under observation, and 1 type III treated by iliac extender insertion) and 1 iliac leg occlusion (treated with femoro-femoral bypass) occurred. We observed a shrinkage of the aneurysmal sac in 8 of 27 cases and stability in 19 of 27 cases; we did not observe any endotension. CONCLUSIONS:Endovascular repair is a good option for emergency treatment of AAAs. The team's experience allows correct planning of the procedure in emergency situations also, with technical results comparable with elective repair. In our experience the bifurcated stent-graft is the device of choice in patients with suitable anatomy because the procedure is less time-consuming than aorto-uni-iliac stent-grafting with surgical crossover, allowing faster aneurysm exclusion. However, further studies are required to demonstrate the long-term efficacy of endovascular repair compared with surgical treatment.
journal_name
Cardiovasc Intervent Radioljournal_title
Cardiovascular and interventional radiologyauthors
Laganà D,Carrafiello G,Mangini M,Fontana F,Caronno R,Castelli P,Cuffari S,Fugazzola Cdoi
10.1007/s00270-005-0080-6subject
Has Abstractpub_date
2006-03-01 00:00:00pages
241-8issue
2eissn
0174-1551issn
1432-086Xjournal_volume
29pub_type
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journal_title:Cardiovascular and interventional radiology
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journal_title:Cardiovascular and interventional radiology
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journal_title:Cardiovascular and interventional radiology
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journal_title:Cardiovascular and interventional radiology
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journal_title:Cardiovascular and interventional radiology
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