title: Endovascular treatment of abdominal aortic anastomotic pseudoaneurysm. The experience of two centers.
abstract: BACKGROUND
  Abdominal aortic pseudoaneurysms are a rare but serious complication of aortic surgery. Treatment with traditional open surgery is associated with a high rate of perioperative mortality and morbidity. Endovascular treatment is less invasive and guarantees lower mortality and morbidity rates. The aim of this study was to evaluate the role of short-, medium- and long-term endovascular treatment of these pseudoaneurysms.
  
  
  METHODS
  Over the past 10 years, 14 patients with abdominal aortic aneurysms, which developed after prior aortic surgery, underwent endovascular treatment involving implantation of an endoprosthesis at our institutions. Exclusion criteria were emergency treatment and suspicion of an infected prosthesis. A Cheatham-platinum covered stent mounted on a balloon catheter was implanted in one patient and self-expandable stent-graft in the other 13. No fenestrated or custom-made prostheses were used.
  
  
  RESULTS
  The procedure had a 100% technical success rate. There was no postoperative mortality. Two type I endoleaks, observed at aortography at the end of the procedure, were not seen on the CT scan taken one month later. Three patients (21.4%) had major perioperative complications which consisted of early occlusion of a branch of the endoprosthesis, (treated with a femoro-femoral crossover bypass graft), a transient ischemic attack, and jaundice. The long-term mortality rate, at an average follow-up of 37.4 months, was 21.4%. None of the deaths was related to the procedure.
  
  
  CONCLUSIONS
  Endovascular treatment of patients who develop anastomotic pseudoaneurysm after surgery of the abdominal aorta is safe and effective both in the short and long term. In our opinion it is the treatment of choice for this category of patients.
authors.affiliation: Department of Vascular and Endovascular Surgery, University of Palermo, Palemo, Italy. umbertomarcello.bracale@unipa.it
authors.forename: Umberto Marcello
authors.initials: UM
authors.lastname: Bracale
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Corte
authors.forename: Luca
authors.initials: L
authors.lastname: Del Guercio
authors.forename: Felice
authors.initials: F
authors.lastname: Pecoraro
authors.forename: Ettore
authors.initials: E
authors.lastname: Dinoto
authors.forename: Giuliana
authors.initials: G
authors.lastname: La Rosa
authors.forename: Massimo
authors.initials: M
authors.lastname: Porcellini
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Bracale
authors.forename: Guido
authors.initials: G
authors.lastname: Bajardi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D057510:Endovascular Procedures; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged