title: Long-term results of aortic banding for complex infrarenal neck anatomy and type I endoleak after endovascular abdominal aortic aneurysm repair.
abstract: For many patients with abdominal aortic aneurysm, unsuitable anatomy of the infrarenal aortic neck precludes endovascular aortic aneurysm repair or causes type I endoleak after the procedure. In an attempt to overcome these challenges, we retrospectively examined the usefulness of aortic banding as an adjunctive procedure to endovascular repair in 8 patients who had an abdominal aortic aneurysm with a complex infrarenal aortic neck. The procedures were performed with the patients under general anesthesia and involved making an 8-cm upper-midline laparotomy incision to expose the aneurysmal aorta. Three patients underwent aortic banding before endovascular repair; the other 5 underwent banding after the repair because of persistent type I endoleak. After banding, the abdominal aortic aneurysm was successfully excluded in all 8 patients. Long-term follow-up (mean, 38±20 mo) revealed no type I endoleak and no procedure-related complications. In patients who have an abdominal aortic aneurysm with complex infrarenal neck anatomy or a refractory type I endoleak, performing aortic banding as an adjunctive procedure to endovascular aortic repair appears to be a safe strategy with good long-term results.
authors.affiliation: Department of Cardiology, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA. ZvonkoMD@aol.com
authors.forename: Zvonimir
authors.initials: Z
authors.lastname: Krajcer
authors.forename: Kathryn G
authors.initials: KG
authors.lastname: Dougherty
authors.forename: Igor D
authors.initials: ID
authors.lastname: Gregoric
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D057867:Endoleak / Q000000981:diagnostic imaging / Q000601:surgery*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Aortic aneurysm, abdominal/complications/surgery; blood vessel prosthesis implantation/adverse effects/methods; patient selection; postoperative complications; risk factors; stents; treatment outcome; vascular surgical procedures/instrumentation