Open versus Endovascular Repair of Para-Anastomotic Aneurysms in Patients Who Were Morphological Candidates for Endovascular Treatment

Gawenda, M.; Zaehringer, Markus; Brunkwall, Jan

doi:10.1177/152660280301000410

Cited by 38 publications

(23 citation statements)

References 37 publications

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“…13 Endovascular techniques carry a number of potential advantages, as they may avoid general anesthesia and aortic clamping, reduce operative blood loss and transfusion requirements, shorten hospital stay, finally limiting the overall physiological stress associated with conventional open surgery. Gawenda et al 2 showed that endovascular repair is safe and effective in this particular setting, reducing perioperative morbidity and complication rates, as stated in previous cases. 10,11 Nevertheless, the "endovascular solution" in these cases has not yet been well defined and should be decided case by case, including different strategies of aneurysm exclusion and presenting with several issues and technical challenges.…”

Section: Discussionmentioning

confidence: 59%

“…1 Usually asymptomatic, it may present clinically as a pulsatile mass or less commonly complicated with rupture. 2,3 Natural history includes frequently life-threatening complications, such as embolization, rupture, and erosion into adjacent organs. Conventional surgical treatment is associated with high mortality rates, ranging from 3 to 70%, 1,2,4-6 due to technical challenges related to dissection through previous scarred operative sites, poor quality of arterial wall and frequent comorbidities of these typically elderly patients.…”

Section: Introductionmentioning

confidence: 99%

“…Conventional surgical treatment is associated with high mortality rates, ranging from 3 to 70%, 1,2,4-6 due to technical challenges related to dissection through previous scarred operative sites, poor quality of arterial wall and frequent comorbidities of these typically elderly patients. 1,2,7 For these reasons endovascular stent grafting, owing to several potential benefits of its minimally invasive approach, represents an attractive therapeutic alternative to conventional surgery 8 and has previously been shown to be feasible. 2,6,[9][10][11][12] We report the first case of a patient who developed a triple paraanastomotic aneurysm following aortobiiliac open reconstruction for abdominal aortic aneurysm and was treated with an endovascular approach.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Endovascular treatment of a triple paraanastomotic aneurysm after aortobiiliac reconstruction

Amato¹,

Kahlberg²,

Bertoglio³

et al. 2008

J. vasc. bras.

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We report a case of a 72-year-old patient considered unfit for open surgery, presenting with paraanastomotic aneurysms of all three anastomoses, 13 years after an open aortobiiliac reconstruction for abdominal aortic aneurysm. This patient was successfully treated with an endovascular approach using a left aortouniiliac endograft and a right iliac tubular endograft, followed by crossover femorofemoral bypass. This report illustrates the usefulness of a minimally invasive approach for solving this complication of aortic open surgery and discusses technical issues related to endovascular devices in this particular setting.Keywords: Pseudoaneurysm, aortic and iliac surgery, endovascular repair, endovascular treatment, anastomosis, postoperative complications. ResumoRelatamos um caso de um paciente de 72 anos não considerado elegível para cirurgia aberta, apresentando aneurismas para-anastomóticos das três anastomoses, 13 anos após uma reconstrução aberta aorto-biilíaca para aneurisma aórtico abdominal. Este paciente foi tratado com sucesso através de abordagem endovascular usando uma endoprótese aorto-uniilíaca esquerda e uma endoprótese tubular ilíaca direita, seguida por derivação cruzada fêmoro-femoral. Este relato ilustra a utilidade de uma abordagem minimamente invasiva para o tratamento desta complicação da cirurgia aórtica aberta e discute questões técnicas relacionadas a dispositivos endovasculares neste contexto em especial. Palavras-chave:Pseudo-aneurisma, cirurgia ilíaca e aórtica, reparo endovascular, tratamento endovascular, anastomose, complicações pós-operatórias.

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Section: Discussionmentioning

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Endovascular treatment of a triple paraanastomotic aneurysm after aortobiiliac reconstruction

Amato¹,

Kahlberg²,

Bertoglio³

et al. 2008

J. vasc. bras.

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“…The lower invasiveness, as compared to classical surgery, and high efficacy of the exclusion of the aneurysmal sac from circulation amounting to 97-98% is evidence that the endovascular method is a full alternative to open surgery (23,24).…”

Section: Discussionmentioning

confidence: 99%

Anastomotic aneurysms- 20-years of experience from one center

Pogorzelski¹,

Fiszer²,

Toutounchi³

et al. 2013

Polish Journal of Surgery

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Anastomotic aneurysms may develop after any type of vascular surgery, in different areas of the arterial system, and require reoperation. The frequency of occurrence of the above-mentioned is estimated at 1-5%. material and methods. During the period between 1989 and 2010, 180 patients with 230 anastomotic aneurysms were subject to surgical intervention at the Department of General and Thoracic Surgery, Warsaw Medical University. The study group comprised 21 (11.7%) female and 159 (88.3%) male patients, aged between 30 and 87 years (mean age -62.8 years). In relation to the number of anastomoses aneurysms were diagnosed in 2.1% of cases. Twenty-four (10.4%) patients were diagnosed with recurrent aneurysms. results. Surgical procedures performed were as follows: artificial prosthesis implantation (119), reanastomosis (40), patch plasty (25), graftectomy (19), prosthesis replacement (9), and stent-graft (7) implantation. 195 (84.8%) aneurysms were subject to planned surgery, while 35 (15.2%) required emergency intervention. 77.8% of patients were diagnosed with aseptic aneurysms, while the remaining 22.2% with infected perioperative aneurysms. Good treatment results were obtained in 149 (82.8%) patients. Limb amputations were performed in 19 (10.5%) cases. Twelve (6.7%) patients died as a consequence of infection and general complications. conclusions. Vascular reoperations are a difficult clinical problem and are burdened with a high rate of complications. The above-mentioned often require complex treatment, in order to improve therapeutic results.

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“…Surgical reintervention is complicated and associated with a high perioperative risk. The mortality rate is 17% for patients undergoing elective surgery and ranges from 66% to 100% in urgent operations [2]. Promising results of endovascular primary abdominal aortic aneurysm treatment prompts one to consider applying the method in order to manage complications following the previous open procedures.…”

Section: Introductionmentioning

confidence: 99%

Endovascular treatment of late complications of open surgical repair in abdominal aortic and iliac segment

Szopiński

Pleban²,

Stryga³

et al. 2018

Acta Angiologica

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Introduction. Promising results of endovascular abdominal aortic aneurysm treatment prompts one to consider applying the method in order to manage complications following the previous open procedures in the aorto-iliac segment. The study aimed at assessing the technical feasibility of applying endovascular methods to manage complications in this group. Material and methods. From December 2009 to August 2018, 26 patients (24 males, 2 females) with a mean age of 72 years, underwent endovascular procedures as reinterventions to manage paraanastomotic aneurysms and new true aneurysms in aorto-iliac segment. Twenty one bifurcated, two branched devices and five tube stent-grafts have been implanted. Results. One immediate open conversion was performed. Eventually, in all of the analysed cases, perianastomotic pseudoaneurysms and true aneurysms were successfully managed. Two cases of type I endoleaks were noticed and managed intraoperatively. No deaths occurred in the perioperative period. In six patients, there were early local complications and early general complications were reported in eight patients. The average length of hospital stay was seven days. Patients have been followed up for 6 to 90 months. No endoleaks nor stent-graft migrations have been reported. Five deaths have been noted not connected with the secondary intervention. Sixteen patients remain in follow-up. Conclusions. Endovascular perianastomotic aneurysm treatment is technically feasible and associated with a low risk of perioperative complications, and a high surgical efficacy. When planning the reintervention, one should take into account the altered anatomy of the aorto-iliac segment. Familiarity with the equipment and experience in the endovascular techniques is of crucial significance.

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Open versus Endovascular Repair of Para-Anastomotic Aneurysms in Patients Who Were Morphological Candidates for Endovascular Treatment

Cited by 38 publications

References 37 publications

Endovascular treatment of a triple paraanastomotic aneurysm after aortobiiliac reconstruction

Endovascular treatment of a triple paraanastomotic aneurysm after aortobiiliac reconstruction

Anastomotic aneurysms- 20-years of experience from one center

Endovascular treatment of late complications of open surgical repair in abdominal aortic and iliac segment

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