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CardioVascular and Interventional Radiology

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01-04-2006 | WORK IN PROGRESS

Emergency Endovascular Treatment of Abdominal Aortic Aneurysms: Feasibility and Results

Authors: Domenico Laganà, Gianpaolo Carrafiello, Monica Mangini, Federico Fontana, Roberto Caronno, Patrizio Castelli, Salvatore Cuffari, Carlo Fugazzola

Published in: CardioVascular and Interventional Radiology | Issue 2/2006

Abstract

Purpose

To assess the feasibility and effectiveness of emergency endovascular treatment of abdominal aortic aneurysms (AAAs).

Methods

During 36 months we treated, on an emergency basis, 30 AAAs with endovascular exclusion. In 21 hemodynamically stable patients preoperative CT angiography (CTA) was performed to confirm the diagnosis and to plan the treatment; 9 patients with hemorrhagic shock were evaluated with angiography performed in the operating room. Twenty-two Excluder (Gore) and 8 Zenith (Cook) stent-grafts (25 bifurcated and 5 aorto-uni-iliac) were used. The follow-up was performed by CTA at 1, 3, 6, and 12 months.

Results

Technical success was achieved in 100% of cases with a 10% mortality rate. The total complication rate was 23% (5 increases in serum creatinine level and 2 wound infections). During the follow-up, performed in 27 patients (1–36 months, mean 15.2 months), 4 secondary endoleaks (15%) (3 type II, 2 spontaneously thrombosed and 1 under observation, and 1 type III treated by iliac extender insertion) and 1 iliac leg occlusion (treated with femoro-femoral bypass) occurred. We observed a shrinkage of the aneurysmal sac in 8 of 27 cases and stability in 19 of 27 cases; we did not observe any endotension.

Conclusions

Endovascular repair is a good option for emergency treatment of AAAs. The team’s experience allows correct planning of the procedure in emergency situations also, with technical results comparable with elective repair. In our experience the bifurcated stent-graft is the device of choice in patients with suitable anatomy because the procedure is less time-consuming than aorto-uni-iliac stent-grafting with surgical crossover, allowing faster aneurysm exclusion. However, further studies are required to demonstrate the long-term efficacy of endovascular repair compared with surgical treatment.

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Title: Emergency Endovascular Treatment of Abdominal Aortic Aneurysms: Feasibility and Results
Authors: Domenico Laganà
Gianpaolo Carrafiello
Monica Mangini
Federico Fontana
Roberto Caronno
Patrizio Castelli
Salvatore Cuffari
Carlo Fugazzola
Publication date: 01-04-2006
Publisher: Springer-Verlag
Published in: CardioVascular and Interventional Radiology / Issue 2/2006
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-005-0080-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Emergency Endovascular Treatment of Abdominal Aortic Aneurysms: Feasibility and Results

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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