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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2000 Dicembre;41(6):871-83

lingua: Inglese

Percutaneous endovascular treatment of peripheral aneurysms

Henry M., Amor M., Henry I., Klonaris C., Tzvetanov K., Buniet J. M., Amicabile C., Drawin T.

From Polyclinique, Essey-les-Nancy Nancy, France


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Back­ground. To eval­uate the fea­sibility and effi­cacy of per­cut­aneous endo­vas­cular treat­ment of periph­eral aneu­rysms.
­Methods. ­Forty-­eight ­patients, M: 41, F: 7, ­mean age: 65.7±10.1 ­years (47-85 ­years), ­with 50 aneu­rysms ­were ­treated: 45 ­with cov­ered ­stents (­Cragg/Pas­sager 22, Cor­vita 21, Wall­graft 1, ­Endotex 1) 4 ­with non-cov­ered ­stents and 1 ­with ­stent ­graft. ­Twenty-six aneu­rysms ­located at the ­iliac ­artery, 12 at the ­femoral and 12 at the pop­li­teal ­artery. ­Mean ­lesion ­length: 61.1±21.3 mm. Per­cut­aneous ­approach ­used in all ­cases, ­femoral ante­grade (n=24), ret­ro­grade (n=23), con­tra­lat­eral (n=2), pop­li­teal (n=1). ­Stents ­used ­were 6-12 mm in diam­eter and 30-120 mm in ­length. Mul­tiple ­stents ­used to ­cover all ­lesions in 20 ­cases.
­Results. Imme­diate tech­nical suc­cess was 96% (48/50). In 1 ­case of ­long, tor­tuous femor­o­pop­li­teal aneu­rysm, it was impos­sible to ­cover the low ­part, due to ­rigidity of the ­device ­used, in 1 ­case of ­large ­iliac aneu­rysm ­there was incom­plete imme­diate exclu­sion. No com­pli­ca­tion ­during the pro­ce­dure. ­Four ­patients devel­oped non-infec­tious ­fever/­local ­pain. ­Eight throm­boses ­occurred: 2 at ­iliac, 1 at ­femoral and 5 at the pop­li­teal ­level. All ­other ­stents ­remained ­patent, the aneu­rysms com­pletely ­excluded ­over a ­mean ­follow-up of 20.6±13.2 m, max­imum 61 m. Pri­mary ­patency: all ­lesions 82%, ­iliac 92%, femor­o­pop­li­teal 78%. Sec­on­dary ­patency: all ­lesions 88%, ­iliac 96%, femor­o­pop­li­teal 86%.
Con­clu­sion. Per­cut­aneous endo­lu­minal treat­ment of periph­eral aneu­rysms ­seems ­safe and effec­tive ­with ­high tech­nical suc­cess and ­good ­long-­term ­results, ­except for pop­li­teal local­iza­tion. It ­could be an alter­na­tive to sur­gery.

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