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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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ORIGINAL ARTICLES  NEW DEVELOPMENTS IN THE MANAGEMENT OF ABDOMINAL AORTIC ANEURYSMS


The Journal of Cardiovascular Surgery 2013 October;54(5):581-7

Copyright © 2013 EDIZIONI MINERVA MEDICA

lingua: Inglese

Percutaneous endovascular aneurysm repair with the ultra-low profile Ovation Abdominal Stent-Graft System

Mangialardi N., Ronchey S., Kasemi H., Alberti V., Fazzini S., Serrao E.

Department of Vascular Surgery San Filippo Neri Hospital, Rome, Italy


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Aim: Aim of the study was to report our single-center experience of the ultra-low profile OvationTM Abdominal Stent-Graft System with totally percutaneous endovascular aneurysm repair (PEVAR).
Methods: Between December 2010 and March 2013 we electively treated 35 patients (male: 89%, mean age: 73±7 years) with abdominal aortic aneurysm (AAA) using bilateral PEVAR with the OvationTM endograft. Most (77%) cases were characterized by challenging femoral artery anatomy. Patients returned for followup visits at 1, 3, 6 months and annually thereafter.
Results: Technical success was 97.1%. One type Ia endoleak was identified on final angiography, which was treated with an extension cuff. No groin complications were observed, including lymphocele, hematoma, pseudoaneurysm, dehiscence, or wound infection. Mean follow-up was 10 months (range 1-24 months). No death was registered. A potential type Ia endoleak was identified at the 30 day follow-up and later confirmed and resolved approximately 12 months after the initial procedure with placement of a Palmaz balloon-expandable stent. No type II, III, or IV endoleaks were identified. No migration, AAA enlargement, AAA rupture, or conversion to open surgery was reported. Two patients (5.7%) developed monolateral iliac limb occlusion at 6 and 50 days follow up, respectively. In one case a limb kinking was observed and treated with iliac kissing stent. The other limb occlusion was due to external iliac artery severe stenosis and was treated with thrombolysis, iliac artery angioplasty, and stenting.
Conclusion: PEVAR with the OvationTM endograft is feasible and safe in patients with unfavorable anatomy.

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n.mangialardi@sanfilipponeri.roma.it