Website is intended for physicians
Search:

 

 

Abstract:

Backgroud: endovascular implantation of the aortic stent-graft is a method of choice in treatment of aneurysms of the infrarenal abdominal aorta, especially in patients with high surgical risk.This strategy is characterized as less in-hospital complications, shorter in-hospital stay All these circumstances show some advantages of endovascular treatment compared with traditional «open» surgery. Besides that, there are some limitations for aortic endoprosthesis implantation, including short or conical proximal neck, severe angulation of aneurysmatic neck and tortuosity of arteries, insufficient diameter of iliac-femoral segment arteries for stent-graft delivery

Materials and methods: we report two clinical cases of successsful implantation of novel stent-graft OVATION PRIME in patients with adverse anatomy, precisely small diameter of crossing profile and original technology of proximal fixation of endoprosthesis.

Results: the use of innovative models of stent-grafts allows to proceed aortic endoprosthesis implantation with minimal risk of complications in certain patients with adverse vascular anatomy, who were previously deemed unsuitable for endovascular treatment.


References

1.     Jackson R.S., Chang D.C. Comparison of long-term survival after open vs endovascular repair of intact abdominal aortic aneurysm among Medicare beneficiaries. JAMA. 2012; 307: 1621-1628.

2.     Logevrove R.E., Javid M., Magee T.R., Galland R.B. A meta-analysis of 21,178 patient undergoing open or endovascular repair of abdominal aortic aneurysm. Br. J. Surg. 2008; 95:677-684.

3.     Brewster D.C., Cronenwett J.L., Hallett J.W. Jr, Johnston K.W., Krupski W.C., Matsumura J.S. Guidelines for the treatment of abdominal aortic aneurysms. Report of a subcommittee of the Joint Council of the American Association for Vascular Surgery and Society for Vascular Surgery. J. Vasc.Surg. 2003;37:1106-17.

4.     Greenhalgh R.M., Brown L.C., Powell J.T., Thompson S.G., Epstein D., Sculpher M.J. Endovascular versus open repair of abdominal aortic aneurysm. N. Engl. J. Med. 2010;362:1863-71.

5.     Lederle F.A., Freischlag J.A., Kyriakides T.C., Padberg F.T. Jr, Matsumura J.S., Kohler T.R., et al. Outcomes following endovascular vs open repair of abdominal aortic aneurysm: a randomized trial. JAMA. 2009; 302:1535-42.

6.     Agency for Healthcare Research and Quality. Healthcare Cost and Utilization Project (HCUP). Available at: http://ahrg.gov/data/hcup/. Accessed September 26, 2012.

7.     Arko F.R. Filis K.A., Seidel S.A., Gonzalez J., Lengle S.J., Webb R., et al. How many patients with infrarenal aneurysms are candidates for endovascular repair? The Northern California experience. J. Endovasc Ther. 2004;11:33-40.

8.     Armon M.P., Yusuf S.W. Latief K., Whitaker S.C., Gregson R.H., Wenham P.W., et al. Anatomical suitability of abdominal aortic aneurysms for endovascular repair. Br. J. Surg. 1997;84:178-80.

9.     Carpenter J.P., Baum R.A, Barker C.F., Golden M.A. Mitchell M.E., Velazquez O.C., et al. Impact of exclusion criteria on patient selection for endovascular abdominal aortic aneurysm repair. J. Vasc.Surg. 2001;34: 1050-4.

10.   Elkouri S., Martelli E., Gloviczki P., McKusick M.A. Panneton J.M., Andrews J.C., et al. Most patients with abdominal aortic aneurysm are not suitable for endovascular repair using currently approved bifurcated stent-grafts. Vasc. Endovascular. Surg. 2004;38:401-12.

11.   Moise M.A., Woo E.Y, Velazquez O.C., Fairman R.M., Golden M.A., Mitchell M.E., et al. Barriers to endovascular aortic aneurysm repair: past experience and implications for future device development. Vasc. Endovascular. Surg. 2006;40:197-203.

12.   Schumacher H., Eckstein H.H., Kallinowski F., Allenberg J.R. Morphometry and classification in abdominal aortic aneurysms: patient selection for endovascular and open surgery. J. Endovasc.Surg. 1997;4:39-44.

13.   Mehta M., Byrne W.J., Robinson H., Roddy S.P, Paty PS., Kreienberg P.B., et al. Women derive less benefit from elective endovascular aneurysm repair than men. J. Vasc. Surg. 2010;55:906-13.

14.   Morrison T., Fillinger M., Meyer C., et al. Gender disparities in endovascular treatment options for infrarenal abdominal aortic аneurysms. http://www.fda.gov/downloads/MedicalDevices/NewsEvents/Workshops Conferences/UCM359044.pdf. Published June 25, 2013. Accessed June 20, 2014.

15.   AbuRahma A.F., Campbell J., Stone PA., et al. The correlation of aortic neck length to early and late outcomes in endovascular aneurysm repair patients. J. Vasc. Surg. 2009;50:738-748.

16.   Aburahma A.F., Campbell J.E., Mousa A.Y, et al. Clinical outcomes for hostile versus favorable aortic neck anatomy in endovascular aortic aneurysm repair using modular devices. J. Vasc.Surg. 2011;54:13-21.

17.   Sweet M.P, Fillinger M.F., MorrisonT.M., Abel D. The influence of gender and aortic aneurysm size on eligibility for endovascular abdominal aortic aneurysm repair. J. Vascular Surg. 2011; 54:931-7. 

ANGIOLOGIA.ru (АНГИОЛОГИЯ.ру) - портал о диагностике и лечении заболеваний сосудистой системы