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Collected Transatlantic Experience From the PERICLES Registry: Use of Chimney Grafts to Treat Post-EVAR Type Ia Endoleaks Shows Good Midterm Results.
- Source :
-
Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists [J Endovasc Ther] 2018 Aug; Vol. 25 (4), pp. 492-498. Date of Electronic Publication: 2018 Jun 18. - Publication Year :
- 2018
-
Abstract
- Purpose: The aim of this retrospective analysis was to evaluate the performance of the chimney (ch) technique in the treatment of type Ia endoleaks after standard endovascular aneurysm repair (EVAR).<br />Methods: Between January 2008 and December 2014, 517 chEVAR procedures were performed in 13 US and European vascular centers (PERICLES registry). Thirty-nine patients (mean age 76.9±7.1 years; 33 men) were treated for persistent type Ia endoleak and had computed tomography angiography or magnetic resonance angiography follow-up at >1 month. Endurant abdominal stent-grafts were used in the 20 cases. Single chimney graft placement was performed in 18 (46%) patients and multiple in 21 (54%). Overall, 70 visceral vessels were targeted for revascularization.<br />Results: Technical success was achieved in 35 (89.7%) cases; 3 persistent type Ia endoleaks and 1 chimney graft occlusion were detected within the first 30 days. Thirty-day mortality was 2.6%. Two other deaths (not aneurysm related) occurred during a mean follow-up of 21.9 months (0.23-71.3). Primary patency of the chimney grafts was 94.3% at 36 months. In a subgroup analysis comparing Endurant to other stent-grafts, no significant differences were observed regarding persistent endoleak [1/20 (5%) vs 2/19 (11%), p=0.6] or reintervention [1/20 (5%) vs 0/19 (0%)].<br />Conclusion: The present series demonstrates that chEVAR in the treatment of post-EVAR type Ia endoleaks has satisfactory results independent of the abdominal and chimney graft combinations. Midterm results show that chEVAR is an effective method for treating type Ia endoleaks.
- Subjects :
- Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal diagnostic imaging
Aortic Aneurysm, Abdominal mortality
Blood Vessel Prosthesis Implantation adverse effects
Blood Vessel Prosthesis Implantation mortality
Endoleak diagnostic imaging
Endoleak etiology
Endoleak mortality
Endovascular Procedures adverse effects
Endovascular Procedures mortality
Europe
Female
Humans
Male
Prosthesis Design
Registries
Reoperation
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
United States
Aortic Aneurysm, Abdominal surgery
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation instrumentation
Endoleak surgery
Endovascular Procedures instrumentation
Stents
Subjects
Details
- Language :
- English
- ISSN :
- 1545-1550
- Volume :
- 25
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists
- Publication Type :
- Academic Journal
- Accession number :
- 29911481
- Full Text :
- https://doi.org/10.1177/1526602818782941