The Long-term Durability of Intra-operatively Placed Palmaz Stents for the Treatment of Type Ia Endoleaks After EVAR of Abdominal Aortic Aneurysm
Abdulrasak, M. LU ; Resch, T. LU ; Sonesson, B. LU ; Holst, J. LU ; Kristmundsson, T. LU and Dias, N. V. LU
(2017)
In European Journal of Vascular and Endovascular Surgery
53(1).
p.69-76
- Abstract
Objective/Background The objective was to analyze the long-term durability of intra-operatively placed Palmaz stents for type Ia endoleaks, and the evolution of aneurysm neck morphology. Methods This was a retrospective cohort study conducted at a tertiary referral centre. Patients treated between 1998 and 2012 were reviewed with regard to pre-, intra-, and post-operative data. Crude and relative survival estimates were calculated, with the latter referring only to patients with ≥ 3 months’ follow-up. Results In total, 125 patients were included (83 elective, 22 ruptures, 20 symptomatic). Nine patients died perioperatively (two elective, seven acute). Median follow-up was 43 months (range 15–72). Seven patients had late abdominal aortic... (More)
Objective/Background The objective was to analyze the long-term durability of intra-operatively placed Palmaz stents for type Ia endoleaks, and the evolution of aneurysm neck morphology. Methods This was a retrospective cohort study conducted at a tertiary referral centre. Patients treated between 1998 and 2012 were reviewed with regard to pre-, intra-, and post-operative data. Crude and relative survival estimates were calculated, with the latter referring only to patients with ≥ 3 months’ follow-up. Results In total, 125 patients were included (83 elective, 22 ruptures, 20 symptomatic). Nine patients died perioperatively (two elective, seven acute). Median follow-up was 43 months (range 15–72). Seven patients had late abdominal aortic aneurysm related deaths. There were 51 re-interventions (seven type Ia endoleak related). Five year crude primary, primary assisted, and secondary success rates were 55 ± 5%, 66 ± 5%, and 70 ± 5%, respectively. These crude rates were superior for elective patients (p = .008, p = .031, and p = .037, respectively), but the relative rates were not (p = .187, p = .640, p = .558, respectively). Primary and assisted freedom from type Ia endoleak 5 years post-operatively were 84 ± 4% and 89 ± 3%, respectively. These rates were superior in elective patients (p = .066 and p = .145, respectively), especially when relative rates were analysed (p = .025 and p = .063, respectively). The visceral aortic diameter increased significantly between the first and the last post-operative imaging in 15/91 (16%), 12/91 (13%), 34/91 (37%), and 30/91 (33%) patients at the levels of coeliac trunk, superior mesenteric artery, lowest renal artery, and 9 mm distal to lowest renal artery, respectively. Conclusion Intra-operatively placed Palmaz stents confer high long-term freedom from type Ia endoleak. Palmaz stents are an acceptable intra-operative bailout tool in the acute setting, but should not be used to extend elective infrarenal endovascular aneurysm repair to more demanding anatomies.
(Less)
- author
- Abdulrasak, M.
LU
; Resch, T.
LU
; Sonesson, B.
LU
; Holst, J.
LU
; Kristmundsson, T.
LU
and Dias, N. V.
LU
- organization
- publishing date
- 2017-01-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Aortic neck anatomy, EVAR, Palmaz stent, Type Ia endoleak
- in
- European Journal of Vascular and Endovascular Surgery
- volume
- 53
- issue
- 1
- pages
- 69 - 76
- publisher
- Elsevier
- external identifiers
-
- pmid:27894897
- wos:000393261600005
- scopus:85007367717
- ISSN
- 1078-5884
- DOI
- 10.1016/j.ejvs.2016.10.004
- language
- English
- LU publication?
- yes
- id
- 16d5d903-cc1b-404a-a22d-f26c6304b7c2
- date added to LUP
- 2017-01-19 14:38:41
- date last changed
- 2024-05-31 21:47:06
@article{16d5d903-cc1b-404a-a22d-f26c6304b7c2,
abstract = {{<p>Objective/Background The objective was to analyze the long-term durability of intra-operatively placed Palmaz stents for type Ia endoleaks, and the evolution of aneurysm neck morphology. Methods This was a retrospective cohort study conducted at a tertiary referral centre. Patients treated between 1998 and 2012 were reviewed with regard to pre-, intra-, and post-operative data. Crude and relative survival estimates were calculated, with the latter referring only to patients with ≥ 3 months’ follow-up. Results In total, 125 patients were included (83 elective, 22 ruptures, 20 symptomatic). Nine patients died perioperatively (two elective, seven acute). Median follow-up was 43 months (range 15–72). Seven patients had late abdominal aortic aneurysm related deaths. There were 51 re-interventions (seven type Ia endoleak related). Five year crude primary, primary assisted, and secondary success rates were 55 ± 5%, 66 ± 5%, and 70 ± 5%, respectively. These crude rates were superior for elective patients (p = .008, p = .031, and p = .037, respectively), but the relative rates were not (p = .187, p = .640, p = .558, respectively). Primary and assisted freedom from type Ia endoleak 5 years post-operatively were 84 ± 4% and 89 ± 3%, respectively. These rates were superior in elective patients (p = .066 and p = .145, respectively), especially when relative rates were analysed (p = .025 and p = .063, respectively). The visceral aortic diameter increased significantly between the first and the last post-operative imaging in 15/91 (16%), 12/91 (13%), 34/91 (37%), and 30/91 (33%) patients at the levels of coeliac trunk, superior mesenteric artery, lowest renal artery, and 9 mm distal to lowest renal artery, respectively. Conclusion Intra-operatively placed Palmaz stents confer high long-term freedom from type Ia endoleak. Palmaz stents are an acceptable intra-operative bailout tool in the acute setting, but should not be used to extend elective infrarenal endovascular aneurysm repair to more demanding anatomies.</p>}},
author = {{Abdulrasak, M. and Resch, T. and Sonesson, B. and Holst, J. and Kristmundsson, T. and Dias, N. V.}},
issn = {{1078-5884}},
keywords = {{Aortic neck anatomy; EVAR; Palmaz stent; Type Ia endoleak}},
language = {{eng}},
month = {{01}},
number = {{1}},
pages = {{69--76}},
publisher = {{Elsevier}},
series = {{European Journal of Vascular and Endovascular Surgery}},
title = {{The Long-term Durability of Intra-operatively Placed Palmaz Stents for the Treatment of Type Ia Endoleaks After EVAR of Abdominal Aortic Aneurysm}},
url = {{http://dx.doi.org/10.1016/j.ejvs.2016.10.004}},
doi = {{10.1016/j.ejvs.2016.10.004}},
volume = {{53}},
year = {{2017}},
}