The durability of endovascular repair of para-anastomotic aneurysms after previous open aortic reconstruction

Abstract

The present study demonstrates that endovascular repair of para-anastomotic aortic and iliac aneurysms after initial prosthetic aortic surgery is safe and durable in patients with an appropriate anatomy. The long-term follow-up showed fewer complications occurred after procedures with bifurcated stent grafts compared with procedures with tube grafts, aortouniiliac, or iliac extension stent grafts.

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

“…8 Gawenda et al reported that lower morbidity and mortality rates post endovascular repair than post open repair. 14 Endovascular repair for PAAs was safer without dissection through the scars from previous operations nor the suprarenal aortic clamping.…”

“…1,6,7 Some clinical reports have suggested that endovascular repair is an alternative management of PPAAs with significantly lower peri-operative mortality rates. [8][9][10][11] However, reports of this procedure with a large series and longer-term follow-up are still quite limited. In this single center study, we presented our results with 24 cases of PPAAs and described our experience.…”

Complementary Role of Fenestrated/Branched Endografting and the Chimney Technique in the Treatment of Pararenal Aneurysms After Open Abdominal Aortic Repair

“…Some of these series reported reintervention and conversion rates of 26.9% and 6.9%, respectively, at a median follow-up of 41 months. 19,20 These poor outcomes reported in the use of standard EVAR are mostly due to endograft migration related to poor quality of the aortic wall and the increased risk of neck enlargement. Today, newer tools, such as giant stents and endoanchors, are available to improve proximal neck sealing.…”

Endovascular repair of abdominal aortic para-anastomotic pseudoaneurysm

“…The endovascular approach has gained importance, with successful results in several case series [6][7][8][9][10] . It reduces morbidity and mortality, particularly in high-risk surgical patients.…”

“…Its initial technical success is about 98% at the time of implantation, and it reduces perioperative mortality to about 3.8% 7,9. Despite the complications associated with endoprostheses, such as endoleaks (type II are the most common), thrombosis, migration, rupture, structural failures and infections, short-and long-term follow-up shows lower complication rates than open surgery. This suggests that the endovascular approach may definitely become the method of choice for the treatment of anastomotic pseudoaneurysms [6][7][8][9] . In the case reported here, the patient underwent follow-up using imaging tests every two years, and a pseudoaneurysm of the distal aortic anastomosis was detected eight years later.…”