Early results with the custom-made Fenestrated Anaconda aortic cuff in the treatment of complex abdominal aortic aneurysm.
Aged
Aortic Aneurysm, Abdominal
/ diagnostic imaging
Aortography
/ methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation
/ adverse effects
Computed Tomography Angiography
Endoleak
/ etiology
Endovascular Procedures
/ adverse effects
Europe
Feasibility Studies
Female
Glomerular Filtration Rate
Humans
Kidney
/ physiopathology
Male
Progression-Free Survival
Prosthesis Design
Retrospective Studies
Risk Factors
Stents
Time Factors
Treatment Outcome
Vascular Patency
Fenestrated Anaconda aortic cuff
Journal
Journal of vascular surgery
ISSN: 1097-6809
Titre abrégé: J Vasc Surg
Pays: United States
ID NLM: 8407742
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
received:
23
01
2018
accepted:
18
05
2018
pubmed:
15
8
2018
medline:
23
4
2019
entrez:
15
8
2018
Statut:
ppublish
Résumé
The objective of this study was to investigate the feasibility of a specific custom-made fenestrated aortic cuff in the treatment of complex abdominal aortic aneurysms (AAAs). Between 2013 and 2016, a total of 57 custom-made Fenestrated Anaconda (Vascutek, Inchinnan, Scotland, UK) aortic cuffs were placed in 38 centers worldwide. All centers were invited to participate in this retrospective analysis. Postoperative and follow-up data included the presence of adverse events, necessity for reintervention, and renal function. Fifteen clinics participated, leading to 29 cases. Median age at operation was 74 years (interquartile range [IQR], 71-78 years); five patients were female. Two patients were treated for a para-anastomotic AAA after open AAA repair, 19 patients were treated because of a complicated course after primary endovascular AAA repair, and 8 cases were primary procedures for AAA. A total of 76 fenestrations (mean, 2.6 per case) were used. Four patients needed seven adjunctive procedures. Two patients underwent conversion, one because of a dissection of the superior mesenteric artery and one because of perforation of a renal artery. Median operation time was 225 minutes (IQR, 150-260 minutes); median blood loss, 200 mL (IQR, 100-500 mL); and median contrast volume, 150 mL (IQR, 92-260 mL). Primary technical success was achieved in 86% and secondary technical success in 93%. The 30-day morbidity was 7 of 29 with a mortality rate of 4 of 29. Estimated glomerular filtration rate remained unchanged before and after surgery (76 to 77 mL/min/m Treatment with this specific custom-made fenestrated aortic cuff is feasible after complicated previous (endovascular) aortic repair or in complex AAAs. The complexity of certain AAA cases is underlined in this study, and the Fenestrated Anaconda aortic cuff is a valid option in selected cases in which few treatment options are left.
Identifiants
pubmed: 30104097
pii: S0741-5214(18)31573-8
doi: 10.1016/j.jvs.2018.05.218
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
348-356Investigateurs
J Falkensammer
(J)
D Kotelis
(D)
S Mylonas
(S)
J Brunkwall
(J)
R H Geelkerken
(RH)
R Meerwaldt
(R)
A Giménez-Gaibar
(A)
A Papaioannou
(A)
K Pfister
(K)
P Kasprzak
(P)
M M P J Reijnen
(MMPJ)
J W H P Lardenoije
(JWHP)
R Williams
(R)
M Delbridge
(M)
G F Fadda
(GF)
R Martinez
(R)
G Rouhani
(G)
B Rylski
(B)
H J M Verhagen
(HJM)
C J Zeebregts
(CJ)
I F J Tielliu
(IFJ)
A de Niet
(A)
Informations de copyright
Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.