Evolution of the upper and lower landing site after endovascular aortic aneurysm repair.Reportar como inadecuado

Evolution of the upper and lower landing site after endovascular aortic aneurysm repair. - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

* Corresponding author 1 LTSI - Laboratoire Traitement du Signal et de l-Image 2 Service de chirurgie thoracique cardiaque et vasculaire Rennes 3 Pharmacologie du Sepsis et Choc Septique CIC - Centre d-Investigation Clinique Rennes 4 Service de radiologie et imagerie médicale Rennes

Abstract : BACKGROUND: The evolution and correlation between the aortic neck and distally located iliac necks after endovascular treatment of abdominal aortic aneurysms AAAs was studied. METHODS: Of 179 patients who had undergone AAA repair between 2003 and 2007, 61 received the same radiologic follow-up and were included in this retrospective study. Data for 61 aortic necks and 115 iliac arteries were analyzed using the preoperative scan, 1-month visit, and final follow-up, with a minimum mean follow-up of 24 ± 15.2 months. Three measurements were taken of the aortic neck: subrenal D1a, 15 mm below the lowest renal artery D1b, and at the origin of the aneurysm D1c. Three measurements were taken at the level of the iliac arteries: origin Da, middle Db, and the iliac bifurcation Dc. These measurements were analyzed using analysis of variance and Spearman correlation coefficient. The results were evaluated for subsequent endoleaks, migrations, and reinterventions. All diameters were compared between patients with a regression of >10% in the greatest diameter of AAA at last follow-up group A, n = 35 and those without group B, n = 26. RESULTS: All diameters in mm increased significantly over time at the level of the proximal neck D1a = 3.7 ± 2.8, P = .018; D1b = 4.4 ± 2.5, P = .016; D1c = 4.3 ± 3.1, P = .036 and iliac arteries Da = 2.1 ± 0.2, P = .0006; Db = 2.5 ± 0.5, P = .0006; Dc = 3 ± 0.7, P = .007. The increase in diameters at the proximal neck and iliac arteries evolved independently insignificant correlation, with the exception of D1b and Dc P = .006, which showed a weak correlation r = 0.363. The group A patients presented increases in all diameters, although to a less significant extent P < .05 than group B patients. During follow-up, a proximal endoleak and a distal endoleak occurred, both requiring reintervention. CONCLUSIONS: Our results show a trend toward dilatation of the aortic neck and iliac arteries, with no correlation between the two levels, even in patients with a regression of the aneurysm sac during follow-up. Although this study found no correlation with the occurrence of endoleaks, our results suggest the need for a longer follow-up, especially on the landing sites.

Autor: Adrien Kaladji - Alain Cardon - Bruno Laviolle - Jean-François Heautot - Guillaume Pinel - Antoine Lucas -

Fuente: https://hal.archives-ouvertes.fr/


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