title: [Endovascular therapy of para-anastomotic aneurysms of the aorta. Technical options].
abstract: BACKGROUND
  Open repair of para-anastomotic aneurysms (pAAA) after conventional aortoiliac repair is associated with a high perioperative mortality and morbidity. Endovascular treatment options have evolved over the last decade. The aim of this article is to demonstrate and review these endovascular strategies.
  
  
  METHODS
  Between 01/2009 and 06/2012, a total of 12 patients received endovascular treatment for proximal (n = 7) or distal (n = 5) pAAA (n = 2 contained rupture). A retrospective analysis of these patients was performed. Median age was 71.5 years (range 55-87 years). The median time interval between primary operation and endovascular repair of the pAAA was 15 years (range 1-31 years) and median follow-up was 1.3 years (range 0 days - 3 years). Endovascular exclusion of the pAAA was achieved by implantation of an aortouniiliac endograft (n = 6), chimney graft (n = 1), fenestrated endograft (n = 2) and iliac extension (n = 3).
  
  
  RESULTS
  Technical success could be achieved in all patients and in-hospital mortality was 16.8  % (n = 2). No patient required a reintervention but during follow-up one additional patient died due to gastrointestinal bleeding. No primary or secondary type I/III endoleaks were observed.
  
  
  CONCLUSIONS
  Despite a not negligible mortality rate endovascular treatment of para-anastomotic aneurysms and anastomotic pseudoaneurysms appears to be a safe alternative for conventional open repair.
authors.affiliation: Klinik für Gefäßchirurgie und Endovaskuläre Chirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland, Alexander.duerr@med.uni-heidelberg.de.
authors.forename: A
authors.initials: A
authors.lastname: Hyhlik-Dürr
authors.forename: M S
authors.initials: MS
authors.lastname: Bischoff
authors.forename: A S
authors.initials: AS
authors.lastname: Peters
authors.forename: N
authors.initials: N
authors.lastname: Attigah
authors.forename: N
authors.initials: N
authors.lastname: Attigha
authors.forename: P
authors.initials: P
authors.lastname: Geisbüsch
authors.forename: D
authors.initials: D
authors.lastname: Böckler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000601:surgery*; D001019:Aortic Rupture / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*; D011474:Prosthesis Design; D012086:Reoperation; D012189:Retrospective Studies
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