Resultados en el corto y mediano plazo de la reparación endovascular de aneurismas de la aorta abdominal y arterias ilíacas: Experience in 28 patients

Abstract

Endovascular repair of abdominal aortic aneuriysms. Experience in 28 patientsBackground: Endovascular repair of aortic aneurysms is less invasive than the traditional surgical approach. Aim: To evaluate the early and mid-term results of aorto-iliac aneurysm endovascular repair. Material and Methods: Analysis of 28 patients aged 59 to 86 years (22 males), subjected to an endovascular repair of aorto-iliac aneurysms between 2007 and 2012. Results: The follow up period of patients ranged from 1 to 65 months. A tri-modular bifurcated prosthesis was installed in 25 patients. A bi-modular bifurcated prosthesis was installed in one patient, an aorto uni iliac prosthesis was installed in one patient; in other patient, a straight endoprosthesis was installed after an abdominal visceral disconnection. In cases of associated iliac aneurysms, unilateral iliac embolization was carried out in seven patients and bilateral embolization in one patient. In one case, the sealing of the hypogastric artery was achieved leaning the prosthetic branch on the hypogastric artery ostium. One patient died 31 days after the operation due to multiple organ failure. One patient died 24 months after surgery due to a gallbladder cancer and other patient died 36 months after surgery due to a rectal cancer. The long-term follow-up showed the presence of type 2 endo-leaks in two patients. The aneurysm decreased in size in 83% of patients after 2 years of follow-up. In five patients, a non-progressive laminar parietal thrombosis inside the endoprosthesis, was observed in the immediate postoperative period. It was initially treated with oral anticoagulants. Conclusions: Endovascular repair of aorto-iliac aneurysms is safe and effective in patients with appropriate anatomical conditions, if a skilled surgical team is available.