Endovascular Repair of Para-Anastomotic Aortoiliac Aneurysms

  • Julian S. Tsang
  • Peter A. Naughton
  • Tim T. Wang
  • Aoife N. Keeling
  • Daragh S. Moneley
  • Michael J. Lee
  • Cathal J. Kelly
  • Austin L. Leahy
Clinical Investigation

DOI: 10.1007/s00270-009-9653-0

Cite this article as:
Tsang, J.S., Naughton, P.A., Wang, T.T. et al. Cardiovasc Intervent Radiol (2009) 32: 1165. doi:10.1007/s00270-009-9653-0

Abstract

The purpose of this study is to evaluate the use of endovascular stent grafts in the treatment of para-anastomotic aneurysms (PAAs) as an alternative to high-risk open surgical repair. We identified all patients with previous open aortic aneurysm repair who underwent infrarenal endovascular aneurysm repair (EVAR) at our institution from June 1998 to April 2007. Patient demographics, previous surgery, and operative complications were recorded. One hundred forty-eight patients underwent EVAR during the study period and 11 patients had previous aortic surgery. Of these 11 redo patients, the mean age was 62 years at initial surgery and 71 years at EVAR. All patients were male. Initial open repair was for rupture in five (45%) patients. The average time between initial and subsequent reintervention was 9 years. All patients were ASA Grade III or IV. Fifty-five percent of the PAAs involved the iliac arteries, 36% the abdominal aorta, and 9% were aortoiliac. Ten patients had endovascular stent-grafts inserted electively, and one patient presented with a contained leak. Aorto-uni-iliac stent-grafts were deployed in seven patients, and bifurcated stent-grafts in four patients. A 100% successful deployment rate was achieved. Perioperative mortality was not seen and one patient needed surgical reintervention to correct an endoleak. Endovascular repair of PAAs is safe and feasible. It is a suitable alternative and has probably now become the treatment of choice in the management of PAAs.

Keywords

Endovascular repairPara-anastomotic aneurysm

Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2009

Authors and Affiliations

  • Julian S. Tsang
    • 1
  • Peter A. Naughton
    • 1
  • Tim T. Wang
    • 1
  • Aoife N. Keeling
    • 2
  • Daragh S. Moneley
    • 1
  • Michael J. Lee
    • 2
  • Cathal J. Kelly
    • 1
  • Austin L. Leahy
    • 1
  1. 1.Department of Vascular Surgery, Royal College of Surgeons in IrelandBeaumont HospitalDublin 9Ireland
  2. 2.Department of Interventional Radiology, Royal College of Surgeons in IrelandBeaumont HospitalDublin 9Ireland