Endovascular exclusion of saccular AAAs using "stacked" AneuRx aortic cuffs.
OBJECTIVE
To show that AneuRx aortic cuffs might be used in a "stacked" configuration to effectively treat saccular abdominal aortic aneurysm (AAA).


METHODS
In a recent 1-year period, 147 patients underwent endovascular AAA repair. Of these, 5 (4 men; mean age 61.6 years, range 55-69) had saccular AAAs with a mean diameter of 3.7 +/- 0.2 cm (range 3.0-4.7). AneuRx aortic cuff prostheses (3.75-cm length) were deployed sequentially in these 5 patients via a right femoral approach; the devices were overlapped approximately 1.5 to 2.0 cm until complete exclusion of the aneurysm was achieved. Endograft surveillance was performed using computed tomography at 4 weeks postoperatively and then every 6 months.


RESULTS
Successful exclusion of the saccular infrarenal aortic aneurysms was achieved in all 5 patients using 2 or 3 "stacked" stent-graft extensions. Four of the 5 procedures were performed under spinal anesthesia; the average procedural time was 96 +/- 41 minutes. The average hospital length of stay was 1.6 days; no major morbidity or mortality was encountered. There were no early or late endoleaks, aneurysm expansion, or device migration over a follow-up that ranged to 12 months.


CONCLUSIONS
Saccular AAA provides ideal anatomy for endovascular repair with a "tube" endograft. "Stacked" aortic cuffs create a customized stent-graft that is not otherwise commercially available.
York
John W
JW
Section of Vascular Surgery, Ochsner Clinic, Alton Ochsner Medical Foundation, 1514 Jefferson Highway, New Orleans, LA 70121, USA.
Sternbergh
W Charles
WC
Lepore
Michael R
MR
Yoselevitz
Moises
M
Money
Samuel R
SR
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000473:pathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents