Use of proximal aortic cuffs as an adjunctive procedure during endovascular aortic aneurysm repair.
The purpose of this study was to evaluate the incidence and durability of additional proximal cuffs during endovascular abdominal aortic aneurysm repair (EVAR). A retrospective review of 90 EVAR patients was conducted. Postoperative survival, proximal sealing zone-related complications, and secondary procedures were analyzed. Additional proximal cuffs were used in 11%. Their use did not affect postoperative survival (p = .58), type I endoleak rate (4.4%; p = .19), or the need for sealing zone-related secondary procedures (6.3%; p = .38) compared with patients without cuff placement but was related to a higher cumulative graft migration rate (2.2% overall p = .02). Two patients (2.5%; p = .79) underwent conversion to open surgery, both for proximal sealing zone-related complications. Application of proximal cuffs appears to be an effective intraoperative adjunctive procedure to achieve a proximal seal during EVAR, with favorable midterm results. However, the risk of late endograft migrations may be elevated in this group.
Biebl
Matthias
M
Section of Vascular Surgery, Mayo Clinic, Jacksonville, FL, USA.
Hakaim
Albert G
AG
Lau
Luk L
LL
Oldenburg
W Andrew
WA
Klocker
Josef
J
Neuhauser
Beate
B
Paz-Fumagalli
Ricardo
R
McKinney
J Mark
JM
Stockland
Andrew
A
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D011475:Prosthesis Failure; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome