PURPOSE: We sought to analyze the clinical and morphologic outcomes of bifurcated stent grafts in patients with ruptured aortoiliac aneurysms at midterm follow-up. METHODS: Thirty-seven patients (4 women; mean age, 73 years; mean abdominal aortic aneurysm [AAA] diameter, 77 mm) underwent endovascular abdominal aneurysm repair between June 1997 and July 2003 for ruptured AAA. Devices inserted were as follows: Vanguard (Boston Scientific, Natick, Mass; n = 7), Excluder (W.L. Gore, Flagstaff, Ariz; n = 25), Talent (Medtronic Vascular, Santa Rosa, Calif; n = 2), and Zenith (Cook Inc, Bloomington, Ind; n = 3). Except for the adjunct postimplantation computed tomographic scanning, the imaging follow-up was the same as for nonruptured AAAs. RESULTS: The mean follow-up period was 24 months (range, 1-59) months. Thirty-day mortality was 10.8%. Three patients died during the follow-up of non-AAA-related causes. One patient was converted early for presumed renal overstenting. The late conversion rate was 9% because of stent graft migration (n = 2) or infection (n = 1). Freedom from endoleak was 57% +/- 8.5% and 48.8% +/- 9% at 2 and 4 years, respectively. Seventeen secondary interventions were performed during the follow-up period, 41% of these within 1 month of stent graft placement. Endoleaks, primary or secondary, were responsible for 58.8% of these interventions. The cumulative risk of a secondary intervention was 35.3% +/- 9% at 2 years and 44.6% +/- 11% at 3 years. Aneurysmal sac shrinkage was observed in 30.8% +/- 9.1% and sac enlargement was observed in 15.3% +/- 10.8% at 2 years. CONCLUSION: Endoluminal devices are able to convert the acute life-threatening situation of ruptured AAA to a controlled situation that results in good patient survival at midterm follow-up.
PURPOSE: We sought to analyze the clinical and morphologic outcomes of bifurcated stent grafts in patients with ruptured aortoiliac aneurysms at midterm follow-up. METHODS: Thirty-seven patients (4 women; mean age, 73 years; mean abdominal aortic aneurysm [AAA] diameter, 77 mm) underwent endovascular abdominal aneurysm repair between June 1997 and July 2003 for ruptured AAA. Devices inserted were as follows: Vanguard (Boston Scientific, Natick, Mass; n = 7), Excluder (W.L. Gore, Flagstaff, Ariz; n = 25), Talent (Medtronic Vascular, Santa Rosa, Calif; n = 2), and Zenith (Cook Inc, Bloomington, Ind; n = 3). Except for the adjunct postimplantation computed tomographic scanning, the imaging follow-up was the same as for nonruptured AAAs. RESULTS: The mean follow-up period was 24 months (range, 1-59) months. Thirty-day mortality was 10.8%. Three patients died during the follow-up of non-AAA-related causes. One patient was converted early for presumed renal overstenting. The late conversion rate was 9% because of stent graft migration (n = 2) or infection (n = 1). Freedom from endoleak was 57% +/- 8.5% and 48.8% +/- 9% at 2 and 4 years, respectively. Seventeen secondary interventions were performed during the follow-up period, 41% of these within 1 month of stent graft placement. Endoleaks, primary or secondary, were responsible for 58.8% of these interventions. The cumulative risk of a secondary intervention was 35.3% +/- 9% at 2 years and 44.6% +/- 11% at 3 years. Aneurysmal sac shrinkage was observed in 30.8% +/- 9.1% and sac enlargement was observed in 15.3% +/- 10.8% at 2 years. CONCLUSION: Endoluminal devices are able to convert the acute life-threatening situation of ruptured AAA to a controlled situation that results in good patient survival at midterm follow-up.
Authors: G Carrafiello; G Piffaretti; D Laganà; F Fontana; M Mangini; A M Ierardi; F Piacentino; A Canì; G Mariscalco; A Di Massa; S Cuffari; P Castelli; C Fugazzola Journal: Radiol Med Date: 2011-09-02 Impact factor: 3.469