Document Detail

Endovascular repair of infrarenal penetrating aortic ulcers: a single-center experience in 20 patients.
MedLine Citation:
PMID:  20681767     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To present the early and midterm results of endovascular stent-graft repair in patients with infrarenal penetrating aortic ulcers (PAU).
METHODS: Between January 1997 and December 2009, 20 patients (17 men; median age 72 years, range 48-85) with PAU of the infrarenal aorta underwent endovascular repair. In this cohort, 2 (10%) patients had a concomitant PAU in the descending thoracic aorta. Indications for treatment were aortic rupture in 2 patients, persistent or recurrent pain in 3 patients, and progression of PAU size or morphological aspects (e.g., thin wall) in the 15 asymptomatic patients. Follow-up included serial aortic imaging at predefined intervals.
RESULTS: The technical success rate was 100%. In-hospital mortality was 10%, with 2 patients dying of myocardial infarction (MI). Postoperative complications were observed in 5 of 20 patients (4 MIs, 1 case of pneumonia, 1 acute on chronic renal failure, and a lymphatic complication at the access site). Primary endoleaks were observed in 4 (20%) patients and a secondary endoleak in 1 patient. The median follow-up was 22.3 months (range 0.4-104). The actuarial survival estimates at 1, 3, and 5 years were 77%, 69%, and 69%, respectively, with no aorta-related death during follow-up. The reintervention rate during follow-up was 10%, including 1 conversion at 11 months for type III endoleak.
CONCLUSION: Patients with PAU have a significant number of cardiovascular comorbidities. The endovascular repair of infrarenal penetrating aortic ulcers thus is accompanied by mortality and morbidity caused predominantly by cardiac complications.
Alexander Hyhlik-Dürr; Philipp Geisbüsch; Drosos Kotelis; Dittmar Böckler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  17     ISSN:  1545-1550     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-04     Completed Date:  2010-11-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  510-4     Citation Subset:  IM    
Department of Vascular and Endovascular Surgery, Ruprecht-Karls University Heidelberg, Germany.
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MeSH Terms
Aged, 80 and over
Aortic Diseases / mortality,  radiography,  surgery*
Aortography / methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation* / adverse effects,  instrumentation,  mortality
Hospital Mortality
Kaplan-Meier Estimate
Middle Aged
Prosthesis Failure
Survival Rate
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Ulcer / mortality,  radiography,  surgery*
Comment In:
J Endovasc Ther. 2010 Aug;17(4):515-6   [PMID:  20681768 ]

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