Fenestrated endovascular aortic repair for juxtarenal abdominal aortic aneurysm.
- Author:
Wei GUO
1
;
Hong-peng ZHANG
;
Xiao-ping LIU
;
Xin JIA
;
Jiang XIONG
;
Xiao-hui MA
Author Information
- Publication Type:Journal Article
- MeSH: Aged; Aged, 80 and over; Aortic Aneurysm, Abdominal; surgery; Blood Vessel Prosthesis Implantation; Endovascular Procedures; methods; Female; Humans; Male; Treatment Outcome
- From: Chinese Medical Journal 2013;126(3):409-414
- CountryChina
- Language:English
-
Abstract:
BACKGROUNDEndovascular stent-graft with fenestration can improve proximal sealing in patients with juxtarenal abdominal aortic aneurysm (JAAA). The purpose of this study was to describe our primary experience and evaluate the safety and efficacy of fenestrated device for JAAA in high-risk patients.
METHODSBetween March 2011 and May 2012, nine male patients (mean age, (79.6 ± 8.6) years) with asymptomatic JAAAs underwent elective deployment of the Zenith fenestrated stent-grafts at a single institution. All patients were treated in the hybrid operating room under general anesthesia. Follow-up computed tomography angiography (CTA) was routinely performed before discharge, at 3, 6, and 12 months and annually thereafter.
RESULTSProcedural success was achieved in all cases. Total sixteen small fenestrations, two large fenestrations and eight scallops were used. Intra-operative complications occurred in four patients, which included one proximal type I endoleak, two type II endoleaks, and one renal artery dissection. The mean hospital stay was (8.9 ± 1.4) days, mean blood loss was (360.5 ± 46.8) ml, and mean iodinated contrast volume was (230.6 ± 58.3) ml. The mean follow-up time was (7.6 ± 4.2) months. The visceral graft patency was 100% until now. One patient had an increase of serum creatinine of more than 30%, but did not require dialysis. No patients died, no stent fractured, and migration were diagnosed during the follow-up.
CONCLUSIONSThe early results of fenestrated device for high-risk patients with complex JAAAs are satisfactory. However, long-term fenestrated graft durability and branch vessel patency remain to be determined.