Dutch experience with the fenestrated Anaconda endograft for short-neck infrarenal and juxtarenal abdominal aortic aneurysm repair

被引:47
作者
Dijkstra, Martijn L. [1 ]
Tielliu, Ignace F. J. [1 ]
Meerwaldt, Robbert [2 ]
Pierie, Maurice [3 ]
van Brussel, Jerome [4 ]
Schurink, Geert Willem H. [5 ]
Lardenoye, Jan-Willem [6 ]
Zeebregts, Clark J. [1 ]
机构
[1] Univ Groningen, Univ Med Ctr Groningen, Div Vasc Surg, Groningen, Netherlands
[2] Med Spectrum Twente, Dept Surg, Div Vasc Surg, Enschede, Netherlands
[3] Isala Clin, Dept Surg, Div Vasc Surg, Zwolle, Netherlands
[4] St Franciscus Gasthuis, Dept Surg, Div Vasc Surg, Rotterdam, Netherlands
[5] Maastricht Univ Med Ctr, Dept Surg, Maastricht, Netherlands
[6] Rijnstate Hosp, Dept Surg, Div Vasc Surg, Arnhem, Netherlands
关键词
SINGLE-CENTER EXPERIENCE; ENDOVASCULAR REPAIR; STENT-GRAFT; PRACTICE GUIDELINES; INITIAL-EXPERIENCE; VASCULAR-SURGERY; MANAGEMENT; SOCIETY; DEVICE; SYSTEM;
D O I
10.1016/j.jvs.2014.02.011
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective: In the past decennium, the management of short-neck infrarenal and juxtarenal aortic aneurysms with fenestrated endovascular aneurysm repair (FEVAR) has been shown to be successful, with good early and midterm results. Recently, a new fenestrated device, the fenestrated Anaconda (Vascutek, Renfrewshire, Scotland), was introduced. The aim of this study was to present the current Dutch experience with this device. Methods: A prospectively held database of patients treated with the fenestrated Anaconda endograft was analyzed. Decision to treat was based on current international guidelines. Indications for FEVAR included an abdominal aortic aneurysm (AAA) with unsuitable neck anatomy for EVAR. Planning was performed on computed tomography angiography images using a three-dimensional workstation. Results: Between May 2011 and September 2013, 25 patients were treated in eight institutions for juxtarenal (n = 23) and short-neck AAA (n = 2). Median AAA size was 61 mm (59-68.5 mm). All procedures except one were performed with bifurcated devices. A total of 56 fenestrations were incorporated, and 53 (94.6%) were successfully cannulated and stented. One patient died of bowel ischemia caused by occlusion of the superior mesenteric artery. On completion angiography, three type I endoleaks and seven type II endoleaks were observed. At 1 month of follow-up, all endoleaks had spontaneously resolved. Median follow-up was 11 months (range, 1-29 months). There were no aneurysm ruptures or aneurysm-related deaths and no reinterventions to date. Primary patency at 1 month of cannulated and stented target vessels was 96%. Conclusions: Initial and short-term results of FEVAR using the fenestrated Anaconda endograft are promising, with acceptable technical success and short-term complication rates. Growing experience and long-term results are needed to support these findings.
引用
收藏
页码:301 / 307
页数:7
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