Transrenal versus infrarenal endograft fixation: influence on type I endoleaks.
The purpose of this study was to compare the rate of proximal type I endoleaks in patients undergoing endoluminal repair of infrarenal abdominal aortic aneurysms with endografts having either transrenal or infrarenal fixation. From September 1998 to May 2000, 42 patients received endoluminal aortic grafts for the treatment of infrarenal abdominal aortic aneurysms. Patients received either transrenal or infrarenal devices, based on the surgeon's preference. All patients had infrarenal aortic neck lengths measuring at least 1.5 cm and proximal neck angulation of <60 degrees. The endoluminal grafts were oversized by 10-20% relative to the diameter of the infrarenal aorta. The presence of endoleaks was determined at the initial procedure by contrast angiography and during subsequent follow-up at 1 month and 3 months by CT scan or duplex ultrasound. No significant differences in the rate of proximal type I endoleaks can be demonstrated between transrenal and infrarenal device types in this small cohort. Proper patient selection is more important than type of proximal fixation in preventing endoleaks.
Division of Vascular Surgery, Washington University School of Medicine, St. Louis, MO, USA. mshames@hsc.usf.edu
Murray
M
Shames
Fred
F
Betros
Bruce
B
Dennien
Anthony
A
Gray-Weale
Eric
E
Lippey
Peter
P
Thursby
Robert
R
Lusby
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000453:epidemiology / Q000601:surgery; D001315:Australia / Q000453:epidemiology; D019917:Blood Vessel Prosthesis Implantation; D003404:Creatinine / Q000097:blood; D020878:Device Removal; D017558:Elective Surgical Procedures; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome
D003404:Creatinine