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Intraoperative proximal endoleaks during AAA stent-graft repair: evaluation of risk factors and treatment with Palmaz stents

Dias, Nuno LU ; Resch, T; Malina, Martin LU ; Lindblad, Bengt LU and Ivancev, Krassi LU (2001) In Journal of Endovascular Therapy 8(3). p.268-273
Abstract
PURPOSE: To study factors that might contribute to intraoperative proximal type I endoleak and to evaluate the placement of giant Palmaz stents as a therapeutic option. METHODS: Thirty-three patients (30 men; median age 72 years, range 50-85) with abdominal aortic aneurysms underwent implantation of fully supported Gianturco Z-stent-based endografts (12 custom-made aortomonoiliac and 21 bifurcated Zenith devices). Ten (30%) patients were treated for intraoperative proximal endoleaks. Stent-graft oversizing and neck angulation, length, and shape were compared between patients with and without leaks. RESULTS: In 9 cases, the endoleaks were successfully treated with intraoperative placement of Palmaz stents without complications. In 1... (More)
PURPOSE: To study factors that might contribute to intraoperative proximal type I endoleak and to evaluate the placement of giant Palmaz stents as a therapeutic option. METHODS: Thirty-three patients (30 men; median age 72 years, range 50-85) with abdominal aortic aneurysms underwent implantation of fully supported Gianturco Z-stent-based endografts (12 custom-made aortomonoiliac and 21 bifurcated Zenith devices). Ten (30%) patients were treated for intraoperative proximal endoleaks. Stent-graft oversizing and neck angulation, length, and shape were compared between patients with and without leaks. RESULTS: In 9 cases, the endoleaks were successfully treated with intraoperative placement of Palmaz stents without complications. In 1 patient, a leak that was resolved intraoperatively with balloon dilation reappeared 1 month later; a Palmaz stent was deployed successfully. Stent-graft oversizing did not differ significantly between patients who developed proximal endoleaks and those who did not (median 4.0 mm in both groups, p = 0.47). Median neck length was 21.0 mm in patients with endoleak and 28.0 mm in those without (p > 0.99). Median neck angulation was 30 degrees in both groups (p = 0.33), and the presence of a conical aneurysm neck was not significantly different (2/10 versus 6/23, p > 0.99). All aneurysms remained excluded at a median follow-up of 13 months (range 6-24). CONCLUSIONS: Stent-graft oversizing and neck morphology (length, angulation, and conical shape) do not seem to correlate with the incidence of proximal type I endoleaks. Palmaz stent placement appears to be a feasible and safe treatment option for this complication. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
abdominal aortic aneurysm, Gianturco Z-stent, Zenith endograft, aortomonoiliac stent-grafting, complication
in
Journal of Endovascular Therapy
volume
8
issue
3
pages
268 - 273
publisher
International Society of Endovascular Specialists
external identifiers
  • pmid:11491261
  • scopus:0034911651
ISSN
1545-1550
DOI
10.1583/1545-1550(2001)008<0268:IPEDAS>2.0.CO;2
language
English
LU publication?
yes
id
567d7334-185e-4631-84e7-77040e130e1a (old id 1120057)
date added to LUP
2008-06-26 12:25:17
date last changed
2018-01-07 06:27:32
@article{567d7334-185e-4631-84e7-77040e130e1a,
  abstract     = {PURPOSE: To study factors that might contribute to intraoperative proximal type I endoleak and to evaluate the placement of giant Palmaz stents as a therapeutic option. METHODS: Thirty-three patients (30 men; median age 72 years, range 50-85) with abdominal aortic aneurysms underwent implantation of fully supported Gianturco Z-stent-based endografts (12 custom-made aortomonoiliac and 21 bifurcated Zenith devices). Ten (30%) patients were treated for intraoperative proximal endoleaks. Stent-graft oversizing and neck angulation, length, and shape were compared between patients with and without leaks. RESULTS: In 9 cases, the endoleaks were successfully treated with intraoperative placement of Palmaz stents without complications. In 1 patient, a leak that was resolved intraoperatively with balloon dilation reappeared 1 month later; a Palmaz stent was deployed successfully. Stent-graft oversizing did not differ significantly between patients who developed proximal endoleaks and those who did not (median 4.0 mm in both groups, p = 0.47). Median neck length was 21.0 mm in patients with endoleak and 28.0 mm in those without (p &gt; 0.99). Median neck angulation was 30 degrees in both groups (p = 0.33), and the presence of a conical aneurysm neck was not significantly different (2/10 versus 6/23, p &gt; 0.99). All aneurysms remained excluded at a median follow-up of 13 months (range 6-24). CONCLUSIONS: Stent-graft oversizing and neck morphology (length, angulation, and conical shape) do not seem to correlate with the incidence of proximal type I endoleaks. Palmaz stent placement appears to be a feasible and safe treatment option for this complication.},
  author       = {Dias, Nuno and Resch, T and Malina, Martin and Lindblad, Bengt and Ivancev, Krassi},
  issn         = {1545-1550},
  keyword      = {abdominal aortic aneurysm,Gianturco Z-stent,Zenith endograft,aortomonoiliac stent-grafting,complication},
  language     = {eng},
  number       = {3},
  pages        = {268--273},
  publisher    = {International Society of Endovascular Specialists},
  series       = {Journal of Endovascular Therapy},
  title        = {Intraoperative proximal endoleaks during AAA stent-graft repair: evaluation of risk factors and treatment with Palmaz stents},
  url          = {http://dx.doi.org/10.1583/1545-1550(2001)008<0268:IPEDAS>2.0.CO;2},
  volume       = {8},
  year         = {2001},
}