title: Morphological and functional modifications of the aneurysm-endograft complex following endoluminal exclusion in 30 consecutive cases.
abstract: Data from 30 consecutive excluded abdominal aortic aneurysms (AAA) have been analysed, to verify whether important morphological changes take place after exclusion, and whether these can be considered as risk factors for functional (leaks, flow alterations) and clinical complications (rupture, obstruction). All AAAs have been initially successfully excluded and patients have been followed up by clinical examinations and ct scan controls post-operatively, at the third and sixth month, then yearly. At a mean follow-up of 17 months, dimension of the proximal neck increased significantly (> 2 mm in diameter) in five pts and graft was distally dislodged in two. Maximum aneurysm diameter reduced significantly (at east 10% than originally) in half of the case and more than 25% in 10% of cases. Four AAAs presented an initial increase, that reduced only in two. Calculation of length of the AAA was unreliable due to tortuosity. Two secondary type II leaks and one secondary type III leak were observed associated to stable or slightly increased AAA diameter (the latter patient suddenly died probably for miocardial infarction, but a rupture could not be formally excluded). Marked tortuosity of the graft was seen in five patients, all associated with frank shrinkage of the aneurysmal sac. Parietal thrombosis without explanation was observed in five, and in one progressed to obstruction of an iliac branch. Two pts needed anticoagulation. These data indicate that endoluminal aneurysm exclusion can not be considered as a definitive solution, for long-term outcome is unforeseeable in a number of patients.
authors.affiliation: Istituto di I Clinica Chirurgica Generale, Università degli studi di Padova. mauro.frego@unipd.it
authors.forename: Mauro
authors.initials: M
authors.lastname: Frego
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bianchera
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kontothanassis
authors.forename: Fabio
authors.initials: F
authors.lastname: Pilon
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ambrosino
authors.forename: Loretta
authors.initials: L
authors.lastname: Di Cristofaro
authors.forename: Elisa
authors.initials: E
authors.lastname: Bonello
authors.forename: Diego
authors.initials: D
authors.lastname: Miotto
authors.forename: Claudio
authors.initials: C
authors.lastname: Fittà
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tropeano
authors.forename: Giulio
authors.initials: G
authors.lastname: Barbiero
mesh_terms: D000328:Adult; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000473:pathology* / Q000503:physiopathology* / Q000601:surgery; D001807:Blood Vessel Prosthesis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors