title: Transrenal E-XL stenting prior to EVAR in the case of abdominal aortic aneurysm associated to proximal aortic neck dissection.
abstract: Chronic dissection of proximal aortic neck is a rare occurrence in patients with abdominal aortic aneurysm (AAA) and a gold standard therapy has not been defined so far. Herein we report two successful cases of an original adjunctive procedure involving the transrenal placement of a self-expanding nitinol stent (E-XL aortic stent, Jotec GmbH, Germany) in order to fix a dissection flap in the aortic neck wall prior to the deployment of the bifurcated endograft. Primary technical success and midterm clinical success was achieved in both cases with freedom from any early or late reintervention. Scheduled follow-up angio-CT scans did not show any Type I endoleak, graft migration or renal/visceral arteries complications. According to these findings, patients with an AAA, presenting with a proximal neck with chronic dissection, can be safely and effectively treated by pre-emptive transrenal E-XL stenting and endovascular aneurysm repair.
authors.affiliation: Cardiovascular Department Vascular and Endovascular Surgery Unit "S. Donato" Hospital, Arezzo, Italy - giorgio.ventoruzzo@libero.it.
authors.forename: G
authors.initials: G
authors.lastname: Ventoruzzo
authors.forename: E
authors.initials: E
authors.lastname: Chisci
authors.forename: S
authors.initials: S
authors.lastname: Croce
authors.forename: F
authors.initials: F
authors.lastname: Turini
authors.forename: S
authors.initials: S
authors.lastname: Michelagnoli
authors.forename: G
authors.initials: G
authors.lastname: Bellandi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D000784:Aortic Dissection / Q000175:diagnosis / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000295:instrumentation*; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000497:Alloys; C013616:nitinol