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Endoluminal treatment of abdominal aortic aneurysms
1Division of Diagnostic and Interventional Radiology, Department of Oncology, Transplants, and Advanced Technologies in Medicine, University of Pisa, Via Roma 67, 56127 Pisa, Italy.
Background:
We report our preliminary results with endovascular treatment of abdominal aortic aneurysms (AAA).
Methods:
Between October 1998 and June 2000, 64 patients (62 male, two female; mean age = 70 years) underwent endovascular repair of AAA. Different types of prostheses were used, both bifurcated (n = 58) and straight (n = 6). We performed duplex sonography and spiral computed tomographic angiography (CTA) at discharge and at 3, 6, 12, and 18 months. Follow-up ranged from 1 to 20 months.
Results:
All procedures were successful, except for three immediate and one late surgical conversions (6.2%). One patient died 14 days after immediate surgical conversion. At discharge, CTA showed 13 endoleaks: three resolved spontaneously, six persisted during follow-up, and four (one angioplasty and three embolizations) were treated successfully. Stenosis of an iliac branch occurred in one patient after 3 months and was successfully treated by angioplasty. Late endoleaks were detected by imaging follow-up in four cases, three at 1 year and one at 6 months, requiring deployment of distal extender cuffs (n = 2), a proximal cuff (n = 1), and lumbar embolization (n = 2).
Conclusion:
Our preliminary experience supports the efficacy of endovascular repair in selected patients, but strict and accurate follow-up is required.