title: Anastomotic pseudoaneurysms after surgical reconstruction: outcomes after endovascular repair of symptomatic versus asymptomatic patients.
abstract: OBJECTIVE
  To compare perioperative and follow-up outcomes of symptomatic versus asymptomatic patients following endovascular repair of anastomotic pseudoaneurysms (APAs) of the abdominal aorta and iliac arteries.
  
  
  METHODS
  We retrospectively evaluated 17 patients (two women), with a mean age of 66.2 years (range 30-83 years). Endovascular treatment was performed in ten symptomatic, and seven asymptomatic patients electively. Data included technical success, perioperative (within 30 days) mortality and morbidity, as well as stent graft-related complications, reinterventions, and survival in follow-up.
  
  
  RESULTS
  Bifurcated (n = 13), aortomonoiliac (n = 3) endoprosthesis and one aortic cuff were implanted with a primary technical success rate of 100%. The overall in-hospital mortality and morbidity rate was 11.8% and 35.3%. The mean survival was 36.5 (range 0-111) months. There was a clear trend toward a lower overall survival within hospital and at one and three years for symptomatic patients compared to asymptomatic patients. (47.7 (CI: 0-138.8) versus 52.6 (CI: 28.5-76.8) months (p = 0.274)). During follow-up, late stent graft related complications were observed in six patients (35.3%) necessitating eight endovascular reinterventions. Additional three patients with primary fistulas between the APA and the intestine were treated by late surgical revision.
  
  
  CONCLUSIONS
  Endovascular therapy of APAs represents a considerable alternative to open surgical repair. Short proximal anchoring zones still pose a risk for endoleaks and unintentional overstenting of side branches with commercially available devices, but this might be overcome by use of fenestrated and branched stent grafts in elective cases.
authors.affiliation: Department of Radiology, Division of Cardiovascular and Interventional Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. richard.nolz@meduniwien.ac.at
authors.forename: Richard
authors.initials: R
authors.lastname: Nolz
authors.forename: Manfred
authors.initials: M
authors.lastname: Gschwendtner
authors.forename: Gregor
authors.initials: G
authors.lastname: Jülg
authors.forename: Christina
authors.initials: C
authors.lastname: Plank
authors.forename: Dietrich
authors.initials: D
authors.lastname: Beitzke
authors.forename: Harald
authors.initials: H
authors.lastname: Teufelsbauer
authors.forename: Andreas
authors.initials: A
authors.lastname: Wibmer
authors.forename: Georg
authors.initials: G
authors.lastname: Kretschmer
authors.forename: Johannes
authors.initials: J
authors.lastname: Lammer
authors.forename: Maria
authors.initials: M
authors.lastname: Schoder
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D017541:Aneurysm, False / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D017543:Iliac Aneurysm / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome