title: Use of proximal aortic cuffs as an adjunctive procedure during endovascular aortic aneurysm repair.
abstract: 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.
authors.affiliation: Section of Vascular Surgery, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Matthias
authors.initials: M
authors.lastname: Biebl
authors.forename: Albert G
authors.initials: AG
authors.lastname: Hakaim
authors.forename: Luk L
authors.initials: LL
authors.lastname: Lau
authors.forename: W Andrew
authors.initials: WA
authors.lastname: Oldenburg
authors.forename: Josef
authors.initials: J
authors.lastname: Klocker
authors.forename: Beate
authors.initials: B
authors.lastname: Neuhauser
authors.forename: Ricardo
authors.initials: R
authors.lastname: Paz-Fumagalli
authors.forename: J Mark
authors.initials: JM
authors.lastname: McKinney
authors.forename: Andrew
authors.initials: A
authors.lastname: Stockland
mesh_terms: 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