Endovascular Treatment of Aorto-Iliac-Femoral Anastomotic Pseudoaneurysms: A Multicentric Study.

Purpose: The purpose of this study was to assess the effectiveness of anastomotic pseudoaneurysms (APAs) endovascular treatment following aorto-iliac-femoral surgical reconstruction.
Basic Procedures: We retrospectively evaluated 54 patients who underwent aorto-iliac-femoral bypass (72 APAs). Follow-up was performed with echo-color-Doppler and/or computed tomography angiography at 1, 3, and 6 months after the procedure and then yearly. We compared clinical success in terms of mortality between aortic APAs and nonaortic APAs (iliac-femoral-popliteal).
Main Findings: Immediate technical success was 100%. No periprocedural complications occurred. Six patients died during follow-up due to causes not related to APA and 5 due to sepsis at 3 months after the procedure. Thirty-day mortality was 9% overall, and we did not register any statistically significant different between aortic APA and nonaortic APA groups. During a mean follow-up of 25.5 months (range: 3-72), we registered 3 occlusions of stent-graft leg, respectively, at 3 days, 7 days, and 24 months after the procedure, 2 type I endoleaks and 1 type III endoleak. Primary clinical success rate was 87.2%, and secondary clinical success was 95.7%.
Conclusions: Endovascular treatment resulted as a valid alternative to open surgery and could be proposed as the treatment of choice for APAs especially in patients with a high surgical risk.
(Copyright © 2017 Elsevier Inc. All rights reserved.)