PURPOSE: To investigate the feasibility, efficacy, and long-term effects of peri-aortic ligatures and Palmaz stenting used to treat proximal type I endoleak after endovascular repair (EVR) of abdominal aortic aneurysm (AAA). METHODS: An 8-year single-center experience with proximal type I endoleak was reviewed; the records of the 55 identified cases were examined to ascertain the methods of treatment used. Among these, all 22 patients who were treated with peri-aortic ligatures and Palmaz stenting were segregated for analysis. RESULTS: The 22 patients (14 men; mean age 74.6 years, range 66-85) with proximal type I endoleak (18 early, 4 late) selected for analysis underwent 23 secondary procedures: 15 involving peri-aortic ligatures and 8 Palmaz stent implantations. Of the 18 early endoleaks, 11 were treated intraoperatively and 7 were observed. Ten (45%) patients died within 30 days of endoleak treatment: 8 had early endoleaks. Five of the 10 deaths occurred in patients successfully treated with peri-aortic ligatures (3/10) or Palmaz stenting (2/7). The 12 (54%) surviving patients suffered no aneurysm-related deaths or secondary endoleaks over a median follow-up of 20 months (range 4-75). CONCLUSIONS: Endoleak is an important mode of failure after endovascular repair. Peri-aortic ligatures and Palmaz stenting are feasible techniques for the treatment of proximal endoleak; however, the perioperative mortality of peri-aortic ligatures was higher when compared with other less invasive techniques. In contrast to other therapeutic options, these methods are more effective in the short and medium term.
PURPOSE: To investigate the feasibility, efficacy, and long-term effects of peri-aortic ligatures and Palmaz stenting used to treat proximal type I endoleak after endovascular repair (EVR) of abdominal aortic aneurysm (AAA). METHODS: An 8-year single-center experience with proximal type I endoleak was reviewed; the records of the 55 identified cases were examined to ascertain the methods of treatment used. Among these, all 22 patients who were treated with peri-aortic ligatures and Palmaz stenting were segregated for analysis. RESULTS: The 22 patients (14 men; mean age 74.6 years, range 66-85) with proximal type I endoleak (18 early, 4 late) selected for analysis underwent 23 secondary procedures: 15 involving peri-aortic ligatures and 8 Palmaz stent implantations. Of the 18 early endoleaks, 11 were treated intraoperatively and 7 were observed. Ten (45%) patients died within 30 days of endoleak treatment: 8 had early endoleaks. Five of the 10 deaths occurred in patients successfully treated with peri-aortic ligatures (3/10) or Palmaz stenting (2/7). The 12 (54%) surviving patients suffered no aneurysm-related deaths or secondary endoleaks over a median follow-up of 20 months (range 4-75). CONCLUSIONS: Endoleak is an important mode of failure after endovascular repair. Peri-aortic ligatures and Palmaz stenting are feasible techniques for the treatment of proximal endoleak; however, the perioperative mortality of peri-aortic ligatures was higher when compared with other less invasive techniques. In contrast to other therapeutic options, these methods are more effective in the short and medium term.
Authors: Salvatore T Scali; Michael M McNally; Robert J Feezor; Catherine K Chang; Alyson L Waterman; Scott A Berceli; Thomas S Huber; Adam W Beck Journal: J Vasc Surg Date: 2014-03-27 Impact factor: 4.268
Authors: Venkatesh K Raman; Parag V Karmarkar; Michael A Guttman; Alexander J Dick; Dana C Peters; Cengizhan Ozturk; Breno S S Pessanha; Richard B Thompson; Amish N Raval; Ranil DeSilva; Ronnier J Aviles; Ergin Atalar; Elliot R McVeigh; Robert J Lederman Journal: J Am Coll Cardiol Date: 2005-06-21 Impact factor: 24.094
Authors: Ali F AbuRahma; Stephen M Hass; Zachary T AbuRahma; Michael Yacoub; Albeir Y Mousa; Shadi Abu-Halimah; L Scott Dean; Patrick A Stone Journal: J Am Coll Surg Date: 2016-12-23 Impact factor: 6.113
Authors: Salvatore T Scali; Adam W Beck; Catherine K Chang; Dan Neal; Robert J Feezor; David H Stone; Scott A Berceli; Thomas S Huber Journal: J Vasc Surg Date: 2015-11-21 Impact factor: 4.268