TY - JOUR
T1 - Endovascular abdominal aneurysm repair and impact of systematic preoperative embolization of collateral arteries
T2 - Endoleak analysis and long-term follow-up
AU - Alerci, Mario
AU - Giamboni, Alessia
AU - Wyttenbach, Rolf
AU - Porretta, Alessandra Pia
AU - Antonucci, Francesco
AU - Bogen, Marcel
AU - Toderi, Marco
AU - Guerra, Adriano
AU - Sartori, Fabio
AU - Tutta, Paolo
AU - Inglese, Luigi
AU - Limoni, Costanzo
AU - Gallino, Augusto
AU - Von Segesser, Ludwig K.
PY - 2013/10
Y1 - 2013/10
N2 - Purpose: To report our results of endovascular aneurysm repair (EVAR) over a 10-year period using systematic preoperative collateral artery embolization. Methods: From 1999 until 2009, 124 patients (117 men; mean age 70.8 years) with abdominal aortic aneurysm (AAA) underwent embolization of patent lumbar and/or inferior mesenteric arteries prior to elective EVAR procedures. Embolization was systematically attempted and, whenever possible, performed using microcoils and a coaxial technique. Follow-up included computed tomography and/or magnetic resonance imaging and abdominal radiography. Results: The technical success for EVAR was 96% (119/124), with 4 patients dying within 30 days (3.2% perioperative mortality) and 1 type III endoleak accounting for the failures. Collateral arteries were occluded spontaneously or by embolization in 60 (48%) of 124 patients. The endoleak rate was 50.9% (74 in 61 patients), most of which were type II (19%). Over a mean clinical follow-up of 60.5±34.1 months (range 1-144), aneurysm sac dimensions decreased in 66 patients, increased in 19 patients, and were stable in 35. The endoleak rate was significantly higher in the patients with increasing sac diameter (p
AB - Purpose: To report our results of endovascular aneurysm repair (EVAR) over a 10-year period using systematic preoperative collateral artery embolization. Methods: From 1999 until 2009, 124 patients (117 men; mean age 70.8 years) with abdominal aortic aneurysm (AAA) underwent embolization of patent lumbar and/or inferior mesenteric arteries prior to elective EVAR procedures. Embolization was systematically attempted and, whenever possible, performed using microcoils and a coaxial technique. Follow-up included computed tomography and/or magnetic resonance imaging and abdominal radiography. Results: The technical success for EVAR was 96% (119/124), with 4 patients dying within 30 days (3.2% perioperative mortality) and 1 type III endoleak accounting for the failures. Collateral arteries were occluded spontaneously or by embolization in 60 (48%) of 124 patients. The endoleak rate was 50.9% (74 in 61 patients), most of which were type II (19%). Over a mean clinical follow-up of 60.5±34.1 months (range 1-144), aneurysm sac dimensions decreased in 66 patients, increased in 19 patients, and were stable in 35. The endoleak rate was significantly higher in the patients with increasing sac diameter (p
KW - Abdominal aortic aneurysm
KW - Aneurysm rupture
KW - Coil embolization
KW - Endoleak
KW - Endovascular aneurysm repair
KW - Inferior mesenteric artery
KW - Lumbar artery
KW - Mortality
KW - Outcome analysis
KW - Preoperative side branch embolization
KW - Sac diameter
KW - Stent-graft
UR - http://www.scopus.com/inward/record.url?scp=84885463137&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84885463137&partnerID=8YFLogxK
U2 - 10.1583/12-4188MR.1
DO - 10.1583/12-4188MR.1
M3 - Article
C2 - 24093319
AN - SCOPUS:84885463137
VL - 20
SP - 663
EP - 671
JO - Journal of Endovascular Therapy
JF - Journal of Endovascular Therapy
SN - 1526-6028
IS - 5
ER -