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Title: Endovascular Treatment of Anastomotic Pseudoaneurysms after Aorto-iliac Surgical Reconstruction

Abstract

Purpose. To assess the effectiveness of endovascular treatment of anastomotic pseudoaneurysms (APAs) following aorto-iliac surgical reconstruction. Materials. We retrospectively evaluated 21 men who, between July 2000 and March 2006, were observed with 30 APAs, 13 to the proximal anastomosis and 17 to the distal anastomosis. The patients had had previous aorto-iliac reconstructive surgery with a bypass due to aneurysm (15/21) or obstructive disease (6/21). The following devices were used: 12 bifurcated endoprostheses, 2 aorto-monoiliac, 4 aortic extenders, 1 stent-graft leg, and 2 covered stents. Follow-up was performed with CT angiography at 1, 3, and 6 months after the procedure and yearly thereafter. Results. Immediate technical success was 100%. No periprocedural complications occurred. Four patients died during follow-up from causes not related to APA, and 1 (treated for prosthetic-enteric fistula) from sepsis 3 months after the procedure. During a mean follow-up of 19.7 months (range 1-72 months), 2 of 21 occlusions of stent-graft legs occurred 3 and 24 months after the procedure (treated with thrombolysis and percutaneous transluminal angioplasty and femorofemoral bypass, respectively) and 1 type I endoleak. Primary clinical success rate was 81% and secondary clinical success was 91%. Conclusion. Endovascular treatment is a valid alternative to open surgery andmore » can be proposed as the treatment of choice for APAs, especially in patients who are a high surgical risk. Further studies with larger series and longer follow-up are necessary to confirm the long-term effectiveness of this approach.« less

Authors:
; ; ; ;  [1];  [2]; ;  [3];  [1]
  1. University of Insubria, Department of Radiology (Italy)
  2. University of Insubria, Department of Anesthesiology (Italy)
  3. University of Insubria, Department of Vascular Surgery (Italy)
Publication Date:
OSTI Identifier:
21090760
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 30; Journal Issue: 6; Other Information: DOI: 10.1007/s00270-007-9047-0; Copyright (c) 2007 Springer Science+Business Media, LLC; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOMEDICAL RADIOGRAPHY; BLOOD VESSELS; BYPASSES; GRAFTS; LEGS; PATIENTS; SURGERY; VASCULAR DISEASES

Citation Formats

Lagana, Domenico, Carrafiello, Gianpaolo, Mangini, Monica, Recaldini, Chiara, Lumia, Domenico, Cuffari, Salvatore, Caronno, Roberto, Castelli, Patrizio, and Fugazzola, Carlo. Endovascular Treatment of Anastomotic Pseudoaneurysms after Aorto-iliac Surgical Reconstruction. United States: N. p., 2007. Web. doi:10.1007/S00270-007-9047-0.
Lagana, Domenico, Carrafiello, Gianpaolo, Mangini, Monica, Recaldini, Chiara, Lumia, Domenico, Cuffari, Salvatore, Caronno, Roberto, Castelli, Patrizio, & Fugazzola, Carlo. Endovascular Treatment of Anastomotic Pseudoaneurysms after Aorto-iliac Surgical Reconstruction. United States. https://doi.org/10.1007/S00270-007-9047-0
Lagana, Domenico, Carrafiello, Gianpaolo, Mangini, Monica, Recaldini, Chiara, Lumia, Domenico, Cuffari, Salvatore, Caronno, Roberto, Castelli, Patrizio, and Fugazzola, Carlo. 2007. "Endovascular Treatment of Anastomotic Pseudoaneurysms after Aorto-iliac Surgical Reconstruction". United States. https://doi.org/10.1007/S00270-007-9047-0.
@article{osti_21090760,
title = {Endovascular Treatment of Anastomotic Pseudoaneurysms after Aorto-iliac Surgical Reconstruction},
author = {Lagana, Domenico and Carrafiello, Gianpaolo and Mangini, Monica and Recaldini, Chiara and Lumia, Domenico and Cuffari, Salvatore and Caronno, Roberto and Castelli, Patrizio and Fugazzola, Carlo},
abstractNote = {Purpose. To assess the effectiveness of endovascular treatment of anastomotic pseudoaneurysms (APAs) following aorto-iliac surgical reconstruction. Materials. We retrospectively evaluated 21 men who, between July 2000 and March 2006, were observed with 30 APAs, 13 to the proximal anastomosis and 17 to the distal anastomosis. The patients had had previous aorto-iliac reconstructive surgery with a bypass due to aneurysm (15/21) or obstructive disease (6/21). The following devices were used: 12 bifurcated endoprostheses, 2 aorto-monoiliac, 4 aortic extenders, 1 stent-graft leg, and 2 covered stents. Follow-up was performed with CT angiography at 1, 3, and 6 months after the procedure and yearly thereafter. Results. Immediate technical success was 100%. No periprocedural complications occurred. Four patients died during follow-up from causes not related to APA, and 1 (treated for prosthetic-enteric fistula) from sepsis 3 months after the procedure. During a mean follow-up of 19.7 months (range 1-72 months), 2 of 21 occlusions of stent-graft legs occurred 3 and 24 months after the procedure (treated with thrombolysis and percutaneous transluminal angioplasty and femorofemoral bypass, respectively) and 1 type I endoleak. Primary clinical success rate was 81% and secondary clinical success was 91%. Conclusion. Endovascular treatment is a valid alternative to open surgery and can be proposed as the treatment of choice for APAs, especially in patients who are a high surgical risk. Further studies with larger series and longer follow-up are necessary to confirm the long-term effectiveness of this approach.},
doi = {10.1007/S00270-007-9047-0},
url = {https://www.osti.gov/biblio/21090760}, journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 6,
volume = 30,
place = {United States},
year = {Thu Nov 15 00:00:00 EST 2007},
month = {Thu Nov 15 00:00:00 EST 2007}
}