title: Endovascular treatment of large and wide aortic neck: case report and literature review.
abstract: Large (24-34 mm) and wide (≥35 mm) aortic necks are a contraindication to endovascular aneurysm repair (EVAR). A 63-year-old man, unfit for conventional surgery, presented a 79 mm abdominal aortic aneurysm with 36.5 mm aortic neck and a 62 mm right common iliac artery aneurysm. He was treated endovascularly with standard commercially available stent-graft using the so-called 'funnel technique'; by placing a thoracic stent-graft inside a bifurcated device to achieve proximal sealing. The completion angiography and the 6 months follow-up with computed tomography showed no stent-graft migration, limb occlusion or endoleak. The literature review reported 179 cases of large aortic neck managed with EVAR, all cases treated with standard devices. Conversely a wide aortic neck was reported in 9; in 2 cases were employed custom-made devices and in 7 standard stent-graft. The use of EVAR with commercially available stent-grafts is feasible and it represents an option especially in non-elective setting.
authors: Vascular Surgery Unit, University of Palermo, AOUP "P. Giaccone", Via L. Giuffrè, 5, 90100, Palermo, Italy. felicepecoraro@libero.it.
authors: Felice
authors: F
authors: Pecoraro
authors: Vascular Surgery Unit, University of Palermo, AOUP "P. Giaccone", Via L. Giuffrè, 5, 90100, Palermo, Italy.
authors: David
authors: D
authors: Pakeliani
authors: Vascular Surgery Unit, University of Palermo, AOUP "P. Giaccone", Via L. Giuffrè, 5, 90100, Palermo, Italy.
authors: Ettore
authors: E
authors: Dinoto
authors: Vascular Surgery Unit, University of Palermo, AOUP "P. Giaccone", Via L. Giuffrè, 5, 90100, Palermo, Italy.
authors: Guido
authors: G
authors: Bajardi
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed
keywords: Complications; Endoleak; Funnel technique; Large neck; Migration