Endovascular repair of proximal para-anastomotic aneurysms after previous open abdominal aortic aneurysm reconstruction

Abstract

Proximal para-anastomotic aneurysms are severe complications after abdominal aortic aneurysm open reconstruction. Closer follow-up and prompt treatment are necessary. Endovascular treatment for proximal para-anastomotic aneurysms is effective, safe and durable. Unibody bifurcated stent graft proved to be suitable for most proximal para-anastomotic aneurysms with various anatomical features.

The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm

“…736,737 Infrarenal and fenestrated endografts have been used with chimney as well as snorkeling techniques. [738][739][740][741][742] Recommendation for postoperative surveillance Systematic reviews by the Society for Vascular Surgery showed a significant incidence of postoperative endoleaks up to 5 years after EVAR, which provides rationale for surveillance. The evidence was insufficient to recommend an optimal frequency of surveillance.…”

Nationwide Experience with EVAS Relining of Previous Open or Endovascular AAA Treatment in The Netherlands

“…Several studies on endovascular treatment (such as ch-EVAR, FEVAR and BEVAR) of paraanastomotic aneurysms after previous open infrarenal AAA repair have demonstrated safety and efficacy, with high technical success (92-100%), a low reintervention rate during up to three-year follow-up (0-18%) and one-year survival of 79-96% [40][41][42][43][44][45][46] . Equally, there are reports on endovascular treatment with FEVAR or BEVAR of failing EVAR demonstrating good clinical outcomes during up to two-year follow-up with high technical success rates (85-100%), low reintervention rates (15-18%) and low AAA-related mortality (2-4%) [45][46][47][48] .…”

Efficacy of Unibody Bifurcated Endovascular Stent-Graft Repair in the Treatment of Abdominal Aortic Aneurysm

“…15 Postoperative follow-up showed that the survival rate of Group B was higher than that of Group A at 6 months, 12 months and 24 The unibody bifurcated stent-graft is suitable for most abdominal aortic aneurysms. 17 However, attention needs to be paid to the following problems in clinical use: First, the unibody bifurcated stent-graft requires a more precise length of the main stent. If the length of the main stent is too long, it can easily block the renal arteryopening; if too short, the tumor cannot be completely isolated and the proximal extension stent needs to be added.…”