The failure of infrarenal aortic open reconstruction due to sterile sovranastomotic abdomimtl aortic aneurysm (SS AAA) is a rare and complex long-term complication. even if they undergo the same treatment, is necessary to distinguish between true aneurysmal degeneration 0f proximal aorta and chronic proximal aortic anastomosis sterile repture with consequent false aneurysm formation: we call proximal paraanastomotic abdominal aortic aneurysm (PPA-AAA) the first and proximal anastomotic false abdominal aortic aneurysm (PAH-AAA) the latter. The ethio logy of this complication is exclusively degenerative and it occurs in the absence of infection, which has totally different features SS-AA have been reported in 1 to 4% patients, but the available studies differ about patient selection and diagnostic methods. According to these considerations we can suppose the real incidence greater and near to 25% in over10 years follow-up patients. chinical fmdings of PPA and PAF-AAA before rupture are poor and this consideration emphasizes the necessity of a long term ultrasound follow-up. best diagnostic tools after ecltographyc detection of SS-AAA are spiral TC scan and MR imaging. Due to image accuracy, the short time necessary to take the images and availability spiral TC has taken the place of standard TC. and arteriography. Scar tissue field and visceral vessels involvement with consequent proximal clamping are the main problems in open repair of SS-AAA. Elective open repair mortality rate vitries from 0 to 17% and increases dramatically after rupture. endovascular repair at the present is suitable only for hardly seleeted cases, because of frequent visceral involvement. We report our 17 patients series (8 PPA and 9 PAF-AAA), which we have observed from 1991 to 2003 in a total amount of 1363 abdominal aortic aneurysnis treated. All the patients have been treated with elective open repair with a global perioperative of 6%(1/17).
|Number of pages||11|
|Journal||Annali Italiani di Chirurgia|
|Publication status||Published - Mar 2004|
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