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Predeployed aortic extension cuff (kilt) in EVAR with hostile neck anatomy using Endurant II system: preliminary results.

Authors :
Szaniewski K
Biernacka M
Walas RL
Zembala M
Source :
Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery [Kardiochir Torakochirurgia Pol] 2016 Dec; Vol. 13 (4), pp. 334-339. Date of Electronic Publication: 2016 Dec 30.
Publication Year :
2016

Abstract

Introduction: Various modifications of standard endovascular aortic aneurysm repair (EVAR) have been developed to solve the problem of difficult neck anatomy.<br />Aim: The authors propose the implantation of a predeployed extension cuff (kilt) using on-shelf Endurant II elements. In a vast majority of cases, the proposed method provides a solution for the hostile neck problem using standard Endurant II elements available in all centers performing subrenal EVAR procedures.<br />Material and Methods: The early outcomes of kilt implantation were evaluated in 11 patients (three with ruptured abdominal aortic aneurysms, one symptomatic) in 2 vascular centers in Silesia (Poland). All patients presented with hostile neck anatomy defined as neck length < 10 mm, diameter > 28 mm, angulation > 60°, mural thrombus or calcium > 2 mm in thickness or > 180° circumference.<br />Results: No intraoperative type I endoleak or device migration was observed. Two perioperative deaths occurred in patients in a severe condition with ruptured aneurysms. One case of type III endoleak was managed by the implantation of an additional iliac extension with complete endoleak sealing.<br />Conclusions: The proposed method seems to be effective in early endoleak prevention in patients with hostile neck anatomy undergoing EVAR procedures; however, studies with long-term follow-up are needed.

Details

Language :
English
ISSN :
1731-5530
Volume :
13
Issue :
4
Database :
MEDLINE
Journal :
Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery
Publication Type :
Academic Journal
Accession number :
28096831
Full Text :
https://doi.org/10.5114/kitp.2016.64876