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Coupling bifurcated stent-grafts to overcome anatomic limitations of endovascular repair of abdominal aortic 무뎌교는

Authors
 Myungsu Lee  ;  Do Yun Lee  ;  Man Deuk Kim  ;  Kwang-Hun Lee  ;  Mu Sook Lee  ;  Sung Il Park  ;  Jong Yun Won  ;  Donghoon Choi  ;  Young-Guk Ko 
Citation
 JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, Vol.23(8) : 1065-1069, 2012 
Journal Title
 JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY 
ISSN
 1051-0443 
Issue Date
2012
MeSH
Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal/diagnostic imaging ; Aortic Aneurysm, Abdominal/surgery* ; Aortography/methods ; Blood Vessel Prosthesis* ; Blood Vessel Prosthesis Implantation/adverse effects ; Blood Vessel Prosthesis Implantation/instrumentation* ; Contrast Media ; Endovascular Procedures/adverse effects ; Endovascular Procedures/instrumentation* ; Feasibility Studies ; Female ; Humans ; Iliac Artery/diagnostic imaging ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Patient Selection ; Predictive Value of Tests ; Prosthesis Design ; Radiographic Image Interpretation, Computer-Assisted ; Republic of Korea ; Retrospective Studies ; Stents* ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome
Keywords
Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal/diagnostic imaging ; Aortic Aneurysm, Abdominal/surgery* ; Aortography/methods ; Blood Vessel Prosthesis* ; Blood Vessel Prosthesis Implantation/adverse effects ; Blood Vessel Prosthesis Implantation/instrumentation* ; Contrast Media ; Endovascular Procedures/adverse effects ; Endovascular Procedures/instrumentation* ; Feasibility Studies ; Female ; Humans ; Iliac Artery/diagnostic imaging ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Patient Selection ; Predictive Value of Tests ; Prosthesis Design ; Radiographic Image Interpretation, Computer-Assisted ; Republic of Korea ; Retrospective Studies ; Stents* ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome
Abstract
PURPOSE: To evaluate the effectiveness of the coupling stent-graft technique and outcomes on contrast-enhanced computed tomography (CT). MATERIALS AND METHODS: All patients who underwent endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAAs) between 2007 and 2010 at a single institution were retrospectively analyzed. Of the 161 cases, 19 patients who had coupling stent-grafting because of AAA proximal neck angulation greater than 60°, conical neck, or iliac tortuosity were included. Patient age ranged from 62 to 87 years (mean, 73.3 y). Mean follow-up was 18.7 months (range, 1-36 mo). The coupling stent-graft technique was defined by the use of suprarenal fixation device main bodies (Zenith or Talent) with one or more EXCLUDER limbs to adapt tortuous and angulated iliac arteries. Pretreatment contrast-enhanced CT was analyzed based on three-dimensional and multiplanar reformatted images. Follow-up contrast-enhanced CT was also analyzed. RESULTS: Mean aneurysm diameter was 68.9 mm ± 14.0, neck length was 32.7 mm ± 15.1, and neck angulation was 68.9° ± 11.5. Conical neck shapes were present in four patients (21.1%) and ruptured AAAs were present in two (10.5%). Among 38 iliac arteries, the mean iliac artery tortuosity index was 1.52 ± 0.27 and iliac angle was 106.8° ± 18.1. Three patients (15.8%) underwent repeat intervention: placement of a balloon-expandable stent in the proximal neck for type I endoleak (n = 1), endovascular embolization for proximal type I endoleak (n = 1), and percutaneous approach following endovascular embolization for type II endoleak (n = 1). No type III endoleak, limb occlusion, limb kinking, or stent-graft migration developed. CONCLUSIONS: The coupling stent-graft technique is technically feasible, with acceptable midterm outcomes in EVAR of AAA in patients with unfavorable neck and iliac anatomies.
Full Text
http://www.sciencedirect.com/science/article/pii/S1051044312003880
DOI
22698969
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Park, Sung Il(박성일)
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Kwang Hun(이광훈)
Lee, Do Yun(이도연)
Lee, Myung Su(이명수)
Lee, Mu Sook(이무숙)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91190
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