ABSTRACT
Objective To observe the long-term efficacy of human fibrin sealant (FS) in the treatment of proximal type Ⅰ endoleak after endovascular aneurysm repair (EVAR) in abdominal aortic aneurysm (AAA).Methods The clinical data of 104 AAA patients with proximal type Ⅰ endoleak receiving EVAR + FS in Changhai Hospital from 2003 to 2012 was retrospectively analyzed,among those 77 cases were with less than 15 mm proximal neck,21 cases with greater than 60 degrees proximal neck angulation,37 cases with severe calcification or thrombosis in proximal neck.After failure of conventional endoleak therapy FS was injected through AAA catheter and long-term efficacy was evaluated by CTA during the follow-up.Results Intra-sac pressure decreased significantly after FS injection.Three patients (2.9％)died perioperatively.Postoperative 1'-,3' and 5 year survival rate was 91.8％,80.6％ and 60.2％respectively.Maximum diameter of AAA decreased from (58.78 ± 13.41) mm to (52.6-± 12.2) mm.There was no FS injection related complications.Conclusion Intra-sac injection of FS is an effective,economical and safe method for treating post-EVAR endoleak,especially for AAA with relatively short and twisted aneurysm neck.
ABSTRACT
Objective To assess the value and safety of stent placement in treating proximal endoleak after endovascular exclusion for abdominal aortic aneurysms.Methods Three patients with primary endoleak and one patient with secondary endoleak underwent implantation of stent. Stents were deployed below renal artery in 1 case and cross bilateral renal arteries in 3 cases. Results In all 4 patients, the stents were successfully implanted and the endoleaks were completely occluded. No complications such as renal function damage, stent shift or endoleak reappearance were observed. Conclusion Stent placement appears to be a feasible, effective and safe treatment option for endoleak after endovascular exclusion for abdominal aortic aneurysms.
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Objective To assess and compare the affects upon renal function after endovascular exclusion (EVE) or conventional surgery (CS) for infrarenal abdominal aortic aneurysms(IAAA). Methods The records of 157 consecutive patients with IAAA from 1997 to 2002 were retrospectively reviewed. There were a group of 115 patients undergoing EVE and a group of 42 patients undergoing CS. The postoperative changes of plasma Cr and BUN with EVE and CS were analyzed respectively and compared. Results The plasma Cr and BUN were significantly increased in the group of CS postoperatively, but no significant difference were shown before and after endovascular repair was discovered in the group of EVE. Moreover, there was a case with acute renal failure in CS group. Conclusion The affects upon renal function with EVE are much less than CS for IAAA patients.