Endovascular repair of aneurysm after previous surgical coarctation repair.
OBJECTIVE
Late aneurysm formation has been reported after every type of surgical coarctation repair, with rupture of such aneurysms being responsible for approximately 7% of all deaths. Secondary surgical repair carries a significant mortality and morbidity. According to the positive experience with endovascular therapy of atherosclerotic thoracic aortic aneurysms, it is worthwhile to evaluate the concept of minimally invasive endovascular stent grafting for secondary repair of postsurgical aneurysms.


METHODS
Data were collected prospectively on consecutive patients who presented with postcoarctation false aneurysms.


RESULTS
Since 1999, in a cohort of 46 endovascularly treated patients with thoracic aortic pathologies, 3 patients with postcoarctation false aneurysms underwent endoluminal stent-graft placement. All of these procedures were technically successful without 30-day or 1-year procedure-related mortality. After a mean follow-up of 19 months (range, 7.8-33.5 months), all aneurysm remain excluded without endoleak.


CONCLUSIONS
According to the current limited experience of small series and short periods of follow-up, the endoluminal repair seems to be a promising alternative to redo operations for postsurgical thoracic aneurysms associated with coarctation repair. Long-term follow-up is required to assess the durability of the stent-graft treatment.
Gawenda
Michael
M
Division of Vascular Surgery, University of Cologne, Cologne, Germany. Michael.gawenda@uk-koeln.de
Aleksic
Marko
M
Heckenkamp
Jörg
J
Krüger
Karsten
K
Brunkwall
Jan
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001017:Aortic Coarctation / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D011446:Prospective Studies; D015607:Stents