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RECENT ADVANCES IN TECHNOLOGY FOR ENDOVASCULAR ANEURYSM REPAIR
Albertini J. N. 1, Perdikides T. 2, Soong C. V. 3, Hinchliffe R.J. 4, Trojanowska M. 5, Yusuf S. W. 6, Clément C. 1, Hopkinson B.R. 4
1 Vascular Surgery Department Hôpital Robert Debré, Reims, France
2 Vascular Surgery Department Hellenic Air Force Hospital, Athens, Greece
3 Vascular Unit, City Hospital Belfast Northern Ireland, UK
4 Vascular Surgery Department Queen’s Medical Centre, Nottingham, UK
5 Department of Interventional Radiology University School of Medicine, Lublin, Poland
6 Vascular Surgery Department Royal Sussex County Hospital, Brighton, UK
Aim. The aim of this paper was to report the results of a multicenter study on endovascular repair of abdominal aortic aneurysms (AAA) in patients with important angulation of the proximal neck using a flexible stent-graft (Aorfix).
Methods. Endovascular repair of AAA using a flexible stent-graft was performed at 16 centers in 29 patients with angulation of proximal neck greater than 45 degrees. Twenty-three patients (79%) had angulation greater than 60 degrees and were therefore contraindicated for repair with other contemporary devices.
Results. Technical success was achieved in all but one case (96%). There was one postoperative death due to multiorgan failure following revision of groin wound for hemorrhage. No patients were converted to open repair. One patient had persisting proximal endoleak despite placement of proximal extension. One patient in whom wireform fractures had been detected died from ruptured aneurysm at nearly 4 year follow-up.
Conclusion. Endovascular repair using a flexible stent-graft is feasible in patients with highly angulated necks. This stent-graft allows the possibiity of a to offer repair for patients unsuitable for the currently available commercial grafts. Mid-term results are acceptable and need to be confirmed by longer follow-up and larger series.