Size of the proximal neck in AAAs treated with balloon-expandable stent-grafts: CTA findings in mid- to long-term follow-up.

PURPOSE: To determine the evolution of the proximal aortic neck diameter in mid- to long-term follow-up after endovascular aneurysm repair of abdominal aortic aneurysm (AAA) with a balloon-expandable stent-graft. METHODS: Thirty patients (27 men; average age 71 years, range 56-87) with infrarenal AAAs were treated with the SETA-Latecba balloon-expandable stent-graft (6 aortomonoiliac and 24 bifurcated configurations). Follow-up ranged from 4 to 8 years (mean 73.4 months). Computed tomography was done systematically before the procedure, after implantation (1-3 months), at 1 year, and annually thereafter. The last follow-up scan was utilized to measure the proximal neck for purposes of comparison with baseline and the initial post-implant scans. RESULTS: Five patients died during follow-up of causes unrelated to the procedure. No endoleaks or graft migrations were observed. The pre-deployment proximal neck diameter (a) averaged 23.4 mm (range 18-32), the diameter after deployment of the stent-graft (b) averaged 24.9 mm (range 18-34), and the most recent follow-up proximal neck measurement (c) averaged 23.8 mm (range 18-31). Comparing the last follow-up to the post-implant measurements (c-b), the neck diameter decreased in 15 (50%) patients [7 with short necks (i.e., <15 mm)] and remained unchanged (no variation) in 15 (50%) patients (4 with short necks). All patients treated with the SETA-Latecba balloon-expandable stent-graft showed stability of the proximal aortic neck diameter in mid- to long-term follow-up. CONCLUSION: The study showed that the diameter reached at initial deployment did not increase further in the long term, which supports the safety and reliability of this modular balloon-expandable stent-graft and illustrates that this device does not produce dilatation of the proximal neck after deployment. Future dilatation of the aortic neck is unlikely, and consequently, migration or delayed type I endoleak are also unlikely.

Procedimientos endovasculares en patología aneurismática de la aorta abdominal en el Hospital Durand / Endovascular procedures in pathology of abdominal aortic aneurysms

Para el tratamiento del aneurisma de la aorta abdominal, el procedimiento intraluminal ofrece mejores resultados hospitalarios y de postoperatorio inmediato que la cirugía convencional, pero lo mas importante para nuestra consideración es darle la oportunidad quirúrgica a pacientes con patologías agregadas y severas que antes del advenimiento de las endoprótesis quedaban sin tratamiento quirúrgico. Se implantaron 26 endoprótesis expansibles por balón, la permeabilidad de las endoprótesis fue en 21 casos (80,76%). Los procedimientos fueron Aortobiilíaca 12 (46,15%) Aorto aèrtica 1 (3,8%) Aortomonoilíaca 13 (50%)

For the elective treatment of abdominal aortic aneurysm, intraluminal procedure provides beter results and postoperative hospital than conventional surgery, but more importantly for us is give you the opportunity to surgical patients with severe diseases and added before stent remained without surgical treatment. Expandable stents were implanted 26 balloon, stent patency was 21 cases (80.76%). The procedures were aorto biilíaca 12 (46.15%) an aorto aortic (3.8%) aorto monoilíaca 13 (50%)