Kilt Technique as an Angle Modification Method for Endovascular Repair of Abdominal Aortic Aneurysm with Severe Neck Angle.
OBJECTIVE
Kilt technique can be useful for overcoming the severe angle in endovascular abdominal aortic repair. Thus, we investigate the utility of the Kilt technique as an angle modification method.


METHODS
This study included 16 patients with abdominal aortic aneurysm having severe neck angle (over 60°). Of these, eight were treated using Kilt technique, whereas the remaining eight were by the conventional endovascular method. We investigated the pre- and post-procedural differences in neck angle between the two groups using aortic computed tomography (CT) angiography.


RESULTS
Mean pre-procedural neck angles in the conventional group and the Kilt group were 70° ± 13° and 93° ± 14° (p = 0.007) and supra-renal neck angles were 54° ± 16° and 89° ± 26°, respectively (p = 0.016). However, the angle differences disappeared between the two groups after the procedure. Consequently, the Kilt group showed greater angle change than the conventional group (p value for ∆ supra-renal angle and ∆ neck angle were 0.015 and 0.021, respectively). There was no type 1 endoleak during 16 ± 16 months of CT follow-up.


CONCLUSIONS
Kilt technique may be an effective tool for modifying the neck angle without leaving increased risk of type 1 endoleak in this subset of patients.
Division of Cardiology, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea.
Tae-Hoon
TH
Kim
Division of Cardiology, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea.
Ho-Jun
HJ
Jang
Division of Cardiology, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea.
Young Jin
YJ
Choi
Department of Radiology, Sejong General Hospital, Bucheon, Korea.
Chang Keun
CK
Lee
Division of Cardiology, Department of Internal Medicine, Inha University Hospital, Incheon, Korea.
Sung Woo
SW
Kwon
Division of Cardiology, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea.
Won-Heum
WH
Shim
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D000072226:Computed Tomography Angiography; D057867:Endoleak / Q000209:etiology; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D061330:Multidetector Computed Tomography; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
Kilt technique; abdominal aortic aneurysm; endovascular abdominal aortic repair