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Endoluminal repair: a better option for the treatment of complex false aneurysms
1Department of Vascular Surgery, Royal Prince Alfred Hospital, University of Sydney, New South Wales, Australia.
Background:
The aim of the present paper is to present the utility of endoluminal repair in the management of complex false aneurysms at various sites throughout the body.
Methods:
Between May 1992 and May 1997 the endoluminal method was used to repair 183 aneurysms at various sites throughout the body. In six patients the pathology was that of false aneurysm and these are the basis of the present report. In two of the patients the false aneurysm was situated between the renal arteries and the proximal end of a previous aortic graft. The other false aneurysms were situated in the right subclavian, the popliteal and internal carotid arteries, in addition to one situated at the junction of two longstanding bypass grafts in the groin. The technique involved delivery of an endograft into the artery from which the false aneurysm had arisen via a sheath inserted through an artery of access which was superficial and remote from the site of the aneurysm. A laparotomy was avoided in the first two cases and thoracotomy avoided in the third case. Opening of the popliteal fossa, which had been the site of a recent knee replacement in the fourth patient, was also avoided.
Results:
Post-procedure angiography confirmed exclusion of the false aneurysm from the general circulation in all six patients. There were no deaths and the mean length of hospital stay was 6 days.
Conclusions:
Endoluminal repair of false aneurysms is feasible and avoids the difficulty and morbidity associated with laparotomy, thoracotomy and operations at sites with scarring from previous interventions.