Elective Endovascular Repair of Abdominal Aortic Aneurysms with Modular and Unibody Type Endografts.

BACKGROUND: In this study, we aimed to evaluate the performance of modular and unibody endografts for the endovascular repair of abdominal aortic aneurysm (AAA). METHODS: Between January 2012 and December 2017, 130 elective infrarenal abdominal aortic aneurysms treated in an endovascular manner were retrospectively evaluated. Sixty-six patients with the modular type (Medtronic EndurantTM II and Lifetech AnkuraTM AAA) and 64 patients with the unibody type (Endologix AFX®) were compared with regards to early and postoperative one-year results. RESULTS: There was one in-hospital mortality (0.8%) in the modular group. There was no difference in postoperative first-year mortality rate between the two groups (p = 0.678). Loco-regional anesthesia was used more often in the unibody group [34 patients (53.1%)] and the use of general anesthesia was higher in the modular group [56 patients (84.8%)] (p < 0.001). While the duration of the procedure was shorter in the unibody group (p < 0.001), no statistically significant difference was found in the duration of fluoroscopy (p = 0.813) and the amount of contrast agent used (p = 0.553). The follow-up period in the intensive care unit was shorter in the modular group (p < 0.001). Moreover, the five-year survival rate was similar between the groups (84.8% in the modular group and 78.4% in the unibody group, log-rank p = 0.703). CONCLUSIONS: The results obtained in our study show that modular and unibody grafts are effective and reliable, although there are some negligible differences in the early period.

Does moderate coronary stenosis affect the fate of the left internal thoracic artery graft?

Abstract Introduction: In this study we try to observe the fate of the left internal thoracic artery grafts that were bypassed to left anterior descending artery with moderate stenosis identified with fractional flow reserve (FFR) technique. Doppler ultrasonography was chosen as a noninvasive screening method. Methods: A total of 30 patients who underwent coronary artery bypass grafting depending on results of the fractional flow reserve between January 2007 and January 2012, were subjected to transthoracic color Doppler ultrasonographic evaluation irrespective of the presence of symptoms, and the presence of a systolic-diastolic flow pattern was investigated using the supraclavicular approach. Results: The left internal thoracic artery graft was found to be functional in 63.3% of patients within a mean period of 35.1±19.7 months between coronary bypass and color Doppler ultrasonography. This period was found to be 29.4±19.6 months in the functional graft group, and 44.7±16.6 months in the dysfunctional graft group (P=0.046). Preoperative complaints of angina were reported to fall from 88.9% to 16.7% in the functional graft group, when compared to the postoperative period (P<0.001), but fell from 90.9% to 36.4% in the dysfunctional graft group (P=0.034). Conclusion: Functional left internal thoracic artery graft rates of the study population were found to be lower than the studies reported in the literature.

Does Moderate Coronary Stenosis Affect the Fate of the Left Internal Thoracic Artery Graft?

INTRODUCTION: In this study we try to observe the fate of the left internal thoracic artery grafts that were bypassed to left anterior descending artery with moderate stenosis identified with fractional flow reserve (FFR) technique. Doppler ultrasonography was chosen as a noninvasive screening method. METHODS: A total of 30 patients who underwent coronary artery bypass grafting depending on results of the fractional flow reserve between January 2007 and January 2012, were subjected to transthoracic color Doppler ultrasonographic evaluation irrespective of the presence of symptoms, and the presence of a systolic-diastolic flow pattern was investigated using the supraclavicular approach. RESULTS: The left internal thoracic artery graft was found to be functional in 63.3% of patients within a mean period of 35.1±19.7 months between coronary bypass and color Doppler ultrasonography. This period was found to be 29.4±19.6 months in the functional graft group, and 44.7±16.6 months in the dysfunctional graft group (P=0.046). Preoperative complaints of angina were reported to fall from 88.9% to 16.7% in the functional graft group, when compared to the postoperative period (P<0.001), but fell from 90.9% to 36.4% in the dysfunctional graft group (P=0.034). CONCLUSION: Functional left internal thoracic artery graft rates of the study population were found to be lower than the studies reported in the literature.