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Thrombotic Occlusion of Stent Graft Limbs due to Severe Angulation of Aortic Neck in Endovascular Repair of Abdominal Aortic Aneurysm

  • Kim, Minsu (Department of Cardiovascular Medicine, Gachon University Gil Medical Center) ;
  • Kim, Myeong Gun (Department of Cardiovascular Medicine, Gachon University Gil Medical Center) ;
  • Kang, Woong Chol (Department of Cardiovascular Medicine, Gachon University Gil Medical Center) ;
  • Oh, Pyung Chun (Department of Cardiovascular Medicine, Gachon University Gil Medical Center) ;
  • Lee, Ji Yeon (Gachon Cardiovascular Research Institute, Gachon University) ;
  • Kang, Jin Mo (Gachon Cardiovascular Research Institute, Gachon University) ;
  • Chung, Wook-Jin (Department of Cardiovascular Medicine, Gachon University Gil Medical Center) ;
  • Shin, Eak Kyun (Department of Cardiovascular Medicine, Gachon University Gil Medical Center)
  • Received : 2015.10.20
  • Accepted : 2015.11.05
  • Published : 2016.09.30

Abstract

Endovascular aneurysm repair (EVAR) is a safe alternative to open surgical repair for an abdominal aortic aneurysm. However, unfavorable aortic anatomy of the aneurysm has restricted the widespread use of EVAR. Anatomic limitation is most often related to characteristics of the proximal neck anatomy. In this report, we described a patient with a severely angulated proximal neck who underwent EVAR, but required repeat intervention because of thrombotic occlusion of stent graft limbs.

Keywords

References

  1. Greenhalgh RM, Brown LC, Kwong GP, Powell JT, Thompson SG; EVAR trial participants. Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomised controlled trial. Lancet 2004;364:843-8. https://doi.org/10.1016/S0140-6736(04)16979-1
  2. United Kingdom EVAR Trial Investigators, Greenhalgh RM, Brown LC, et al. Endovascular versus open repair of abdominal aortic aneurysm. N Engl J Med 2010;362:1863-71. https://doi.org/10.1056/NEJMoa0909305
  3. Hobo R, Kievit J, Leurs LJ, Buth J; EUROSTAR Collaborators. Influence of severe infrarenal aortic neck angulation on complications at the proximal neck following endovascular AAA repair: a EUROSTAR study. J Endovasc Ther 2007;14:1-11. https://doi.org/10.1583/06-1914.1
  4. Leurs LJ, Kievit J, Dagnelie PC, Nelemans PJ, Buth J; EUROSTAR Collaborators. Influence of infrarenal neck length on outcome of endovascular abdominal aortic aneurysm repair. J Endovasc Ther 2006;13:640-8. https://doi.org/10.1583/06-1882.1
  5. Sampaio SM, Panneton JM, Mozes GI, et al. Proximal type I endoleak after endovascular abdominal aortic aneurysm repair: predictive factors. Ann Vasc Surg 2004;18:621-8. https://doi.org/10.1007/s10016-004-0100-z
  6. Choke E, Munneke G, Morgan R, et al. Outcomes of endovascular abdominal aortic aneurysm repair in patients with hostile neck anatomy. Cardiovasc Intervent Radiol 2006;29:975-80. https://doi.org/10.1007/s00270-006-0011-1
  7. Bastos Goncalves F, Hoeks SE, Teijink JA, et al. Risk factors for proximal neck complications after endovascular aneurysm repair using the endurant stentgrafts. Eur J Vasc Endovasc Surg 2015;49:156-62. https://doi.org/10.1016/j.ejvs.2014.10.003
  8. Aburahma AF, Campbell JE, Mousa AY, et al. Clinical outcomes for hostile versus favorable aortic neck anatomy in endovascular aortic aneurysm repair using modular devices. J Vasc Surg 2011;54:13-21. https://doi.org/10.1016/j.jvs.2010.12.010
  9. AbuRahma AF, Campbell J, Stone PA, et al. The correlation of aortic neck length to early and late outcomes in endovascular aneurysm repair patients. J Vasc Surg 2009;50:738-48. https://doi.org/10.1016/j.jvs.2009.04.061
  10. Faure EM, Becquemin JP, Cochennec F; ENGAGE collaborators. Predictive factors for limb occlusions after endovascular aneurysm repair. J Vasc Surg 2015;61:1138-45.e2. https://doi.org/10.1016/j.jvs.2014.11.084

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