[Clinical application of "Anatomical fixation" in the endovascular repair of abdominal aortic aneurysm].
OBJECTIVE
This paper aims to evaluate the clinical applyment of "Anatomical fixation" and its long-term efficacy .


METHODS
Retrospective analysis of clinical data and postoperative follow-up results of 125 patients undogoing EVAR using "anatomical fixation" enrolled in Shanghai Changhai hospital and Shanghai Changzheng hospital from January 2008 to January 2013.


RESULTS
The technical success rate was 100%, Perioperative complications including Type I endoleak occurred in 3 patients (2.4%), 4 cases of type II endoleak (3.2%). Incidence of Type I endoleak in challenging neck cases was high than non- challenging neck cases, the difference was statistically significant (P < 0.001). After 30 days and through current follow-up of 124 successful cases(mean:26.4 ± 1.5 months, range 1-60 months). No rupture of the aneurysm and stent graft migrations occurred. Secondary type I endoleak in 2 cases (1.6%), Two cases of secondary type II endoleak (1.6%). Left lower extremity arterial thrombosis in 1 case (0.8%), and secondary surgical intervention in 1 case (0.8%). Three cases of deaths in cumulative, 2 patients died died of acute myocardial infarction. At 3 months, a patient died of the contrast-induced nephropathy, renal failure.


CONCLUSIONS
The clinical applyment of "Anatomical fixation" enriched the theory of EVAR, completely solved the complication of incidence of stent-graft migration, greatly improve the repair rate of hostile neck cases, expand the indications for EVAR.
Department of Vascular and Endovascular Surgery , Changzheng Hospital, Second Military Medical University , Shanghai 200003 , China.
Jun
J
Bai
Department of Vascular and Endovascular Surgery , Changzheng Hospital, Second Military Medical University , Shanghai 200003 , China. Email: qulefeng@gmail.com.
Lefeng
L
Qu
Department of Vascular and Endovascular Surgery , Changzheng Hospital, Second Military Medical University , Shanghai 200003 , China.
Kangkang
K
Zhi
Department of Vascular and Endovascular Surgery , Changzheng Hospital, Second Military Medical University , Shanghai 200003 , China.
Zhiwei
Z
Gao
Department of Vascular and Endovascular Surgery , Changzheng Hospital, Second Military Medical University , Shanghai 200003 , China.
Yongfa
Y
Wu
Department of Vascular and Endovascular Surgery , Changzheng Hospital, Second Military Medical University , Shanghai 200003 , China.
Liang
L
Xu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome