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Published on: November 21, 2019
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Pararenal Aortic Ulcer Repair.
F Taher1, A Assadian1, J Strassegger1
1Wilhelminenspital Vienna, Department of Vascular and Endovascular Surgery, Montleartstraße 37, 1160 Vienna, Austria.
Summary
Pararenal penetrating aortic ulcers (PAUs) show encouraging results with endovascular repair, including EVAR and FEVAR. While technical success was 100%, one fatal complication highlights the risks of these complex aortic repair techniques.
Area of Science:
- Vascular Surgery
- Endovascular Interventions
- Aortic Disease Management
Background:
- Pararenal penetrating aortic ulcers (PAUs) represent a complex subset of aortic pathology.
- Investigating repair techniques and outcomes is crucial for improving patient management.
Purpose of the Study:
- To evaluate the techniques and outcomes of pararenal penetrating aortic ulcer (PAU) repair.
- To assess technical success, survival, peri-operative complications, and stent patency.
Main Methods:
- Retrospective cohort study of 12 patients treated for pararenal PAU over a 6-year period.
- Treatment modalities included hybrid procedures (EVAR + bypass), chimney EVAR (Ch-EVAR), and fenestrated EVAR (FEVAR).
Main Results:
- 100% technical success rate observed across all treatment modalities.
- Symptomatic patients had greater PAU protrusion; perforation/leakage correlated with pre-operative pain.
- One major complication (stroke, paralysis, death) occurred with FEVAR; one endoleak required re-intervention with Ch-EVAR.
Conclusions:
- Endovascular repair of pararenal PAUs demonstrates promising outcomes.
- FEVAR is increasingly preferred for elective repair due to increased awareness and planning capabilities.
- Ch-EVAR and hybrid procedures were mainly used for symptomatic patients, while FEVAR was favored for elective cases.
