Document Detail


Midterm results of the Zenith endograft in relation to neck length.
MedLine Citation:
PMID:  20831986     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Successful endovascular repair of abdominal aortic aneurysms (AAAs) requires specific infrarenal neck anatomy to allow for a durable seal and fixation. This is a single-center study reviewing outcomes in relation to neck length after placement of a Zenith endograft.
METHODS: Retrospective single-center review of all AAAs electively repaired with a Zenith endograft during a recent 5-year period. Patients were divided into those with infrarenal necks 4-15 mm in length and those >15 mm using center line measurements. Clinical outcomes and follow-up computed tomography scans were reviewed.
RESULTS: Between 2003 and 2008, 318 patients underwent elective repair of an infrarenal AAA with the Zenith endograft. Of 318 patients, 68 (21.4%) had necks measuring 4-15 mm in length and 250 (79.5%) had necks measuring >15 mm. Overall early mortality was 0.9% (p = 0.11) and the rate of type II endoleaks was 19% (p = 0.11); neither differed between the groups. Four patients in each group had immediate proximal type I endoleaks, which resolved spontaneously in two patients in each group. The remaining two in each group required further intervention (two endovascular and two conversion to open repair). Type I endoleaks and reinterventions did not differ statistically between groups (p = 0.06). On further analysis, those patients requiring reintervention or conversion for type I endoleaks had other unattractive neck features (large diameter, angulation). There have been no instances of new type I endoleaks during 5-yearfollow-up period.
CONCLUSION: These midterm results indicate that patients with shorter infrarenal necks can be treated as effectively as those with longer necks with the Zenith endograft unless these necks are tortuous or wide.
Authors:
Thomas L Forbes; Jeremy R Harris; D Kirk Lawlor; Guy Derose
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of vascular surgery     Volume:  24     ISSN:  1615-5947     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-13     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  859-62     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Division of Vascular Surgery, London Health Sciences Centre and the University of Western Ontario, London, Ontario, Canada. Tom.Forbes@lhsc.on.ca
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MeSH Terms
Descriptor/Qualifier:
Aortic Aneurysm, Abdominal / mortality,  radiography,  surgery*
Aortography / methods
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / adverse effects,  instrumentation*,  mortality
Endoleak / etiology,  surgery
Endovascular Procedures / adverse effects,  instrumentation*,  mortality
Humans
Ontario
Prosthesis Design
Reoperation
Retrospective Studies
Stents*
Time Factors
Tomography, X-Ray Computed
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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