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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2006 December;19(6):421-5
The endovascular treatment of false aortic and iliac aneurysms
Szmidt J. 1, Galazka Z. 1, Rowinski O. 2, Nazarewski S. 1, Grochowiecki T. 1, Pacho R. 2, Wojtaszek M. 1, Jakimowicz T. 1, Kanski A. 3, Pietrasik K. 1, Nawrot I. 1
1 Department of General, Vascular and Transplant Surgery Medical University of Warsaw, Poland
2 2nd Department of Radiology Medical University of Warsaw, Poland
3 2nd Department of Anaesthesia and Intensive Therapy Medical University of Warsaw, Poland
Aim. With the advancement of diagnostic modalities we observe an increased incidence of diagnosed false aneurysms of the abdominal aorta (FAA) and iliac arteries (FIA). The catheterization of major vessels may also play an important role in the formation of FAA's. Traditional surgery presents a technical challenge, with significant morbidity and mortality rates. This study was conducted to determine the long-term results of endovascular techniques in the exclusion of false aortic and iliac aneurysms.
Methods. Eleven of 309 (3.6%) patients undergoing endovascular repair for AAA were diagnosed preoperatively to have a false aneurysm, with 9 patients diagnosed with FAA and 2 patients with FIA. Three patients had prior reconstructive aortic surgery. All patients were male with a mean age of 67.1 years (range 54 to 75 years). At time of diagnosis mean diameters were 42.4 ± 4.4 mm (range 34 - 49) for FAA and 60 and 120 mm for the two FIA.
Results. Pseudoaneurysm repair was achieved in 6 patients with a bifurcated or unilateral stentgraft and in 3 patients using a straight tube stentgraft. Two patients with false iliac aneurysms underwent repair with stentgraft iliac limbs. Endograft deployment was successful in all patients with no observed endoleaks on intraoperative digital subtraction angiography or in the first postoperative CT scan. There were no deaths and no serious postoperative complications.
Conclusions. These results show the safety, feasibility and viability of endovascular exclusion for the treatment of iatrogenic lesions of the abdominal aorta in patients after previous aortic surgery or burdened with significant co morbidities.