Midterm Results of a Modified Technique for Implanting Tube Grafts During Endovascular Abdominal Aortic Aneurysm Repair

ArticleinJournal of Endovascular Therapy 15(4):433-40 · August 2008with8 Reads
DOI: 10.1583/08-2411.1 · Source: PubMed
Abstract
To retrospectively analyze the efficacy and midterm results of endovascular aneurysm repair (EVAR) with a tubular stent-graft using 2 different implantation techniques. Between November 2004 and September 2007, 53 patients (49 men; mean age 68.5+/-8.6 years, range 40-80) were treated with the EndoFit tube stent-graft. The majority (45, 85%) were treated using the trombone technique, in which 2 tubular aortoaortic endografts were deployed with 4 to 8 cm of overlap. This subgroup was compared to the 8 patients who received single tube grafts. Technical and procedural success were 100%; perioperative mortality was 0%. Operative results were similar for patients treated with 1 graft versus those treated with the overlapping trombone technique. The overall device-related complication rate was significantly lower for patients treated with the trombone technique (11% versus 75%, p<0.001). Mean follow-up was 24 months (range 6-36). Endoleak type II occurred in 3 (5.7%) cases. Three (5.7%) patients died, 1 from an aortoduodenal fistula secondary to a proximal type I endoleak and 2 from acute myocardial infarction. The tubular EndoFit device appears both safe and effective in terms of midterm clinical outcome, especially when the trombone technique is utilized. It compares favorably with previously reported EVAR results.
    • "The implantation procedure is easier and quicker; the contralateral common femoral artery is not surgically exposed, lowering the risk for postoperative wound-related complications; and the overall cost of EVAR is substantially reduced even though in cases where 3 grafts are used this is can be discussed. Tubular endografts are also largely free of the kinking, twisting, and resulting thrombosis that may occur in the limbs of bifurcated devices and aortomonoiliac devices234. In addition, the use of the trombone technique makes it possible to treat anatomies with differing proximal and distal aortic neck diameters, avoiding conical grafts. "
    Article · Jan 2014
    • "He described very promising early and midterm results, which compared favorably to those reported for bifurcated devices and open repair. In 2008 Saratzis and Coll. [9] too evaluated this technique comparing outcomes of 45 patients electively treated for AAA using the trombone technique to 8 patients who received single tube grafts. They observed that the overall device-related complication rate was significantly lower for patients treated with the trombone technique (11% versus 75%, p = .001). "
    [Show abstract] [Hide abstract] ABSTRACT: Background: We describe our 8-year experience with the use of endovascular techniques (ET) for the treatment of abdominal aortic aneurysms (AAA) through a straight endograft. Methods: We retrospectively reviewed data of all patients who were treated for AAA using ET in two centres from 1998 to 2012 and who received a single straight endograft (group A) or a double straight tube (group B). Outcomes were analyzed to assess survival, absence of endoleak and absence of reintervention for both groups. Log-rank and Chi-Square were used as appropriate to make comparison between the two groups. P values < .05 were considered statistically significant. Results: Fifty-three patients from 1998 to May 2012 were treated for AAA using a straight endograft. In 28 cases (52.8%) a single aortic straight tube was used (Group A), while in the remaining cases a "double trombone technique" was used (Group B). Conclusions: In our experience the endovascular repair of AAA using straight aortic endografts was a safe and effective technique. Reintervention and endoleaks were slightly more frequent in patients who had received a single endograft compared to patients who were treated using the "trombone technique".
    Full-text · Article · Apr 2013
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