[Endovascular repair of infrarenal abdominal aortic aneurysm with the complex aortic anatomy].
OBJECTIVE
To explore the safety and efficiency of endovascular repair (EVAR) of abdominal aortic aneurysms (AAAs) which have the complex aortic anatomy.


METHODS
The clinical date of 48 AAA patients with complex aortic anatomy treated by EVAR from January 2003 to March 2011 was retrospectively analyzed. There were 37 male and 11 female patients, aged from 50 to 81 years with a mean of 71.4 years. Fourteen patients had short aortic neck (< 15 mm), 13 patients had severe infrarenal angulation (> 60°), 15 patients had severely tortuous iliac, 6 patients had small iliac (< 8 mm). The stent-grafts were deployed by both femoral arteries to treat the AAA.


RESULTS
The primary technical success rate was 100%. The perioperative survival rate was 100%. Intraoperative angiograms revealed two type I endoleaks, in which one disappeared in two weeks, another existed. Follow-up was available in 40 patients with a median of 63 months (4 to 122 months). During the follow-up period, 2 patients died with no relationship to the procedures. The rest patients survived well. The accumulative survival rate was 95.8%. There were no new endoleak, stent-graft migration, aneurysm expansion, or secondary intervention during the follow-up time.


CONCLUSIONS
EVAR is safety and efficiency to treat the patient of infrarenal abdominal aortic aneurysm with the complex aortic anatomy. By the accumulation of experience, EVAR will play a more important role for these patients.
Department of Vascular Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China. changshu01@yahoo.com
Chang
C
Shu
Jian
J
Qiu
Xiao-lei
XL
Hu
Tun
T
Wang
Quan-ming
QM
Li
Ming
M
Li
D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000033:anatomy & histology*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome