Fenesztrált stent-graft beültetés Magyarországon.

ABSTRACT

CASE REPORT The first case was a 77-year-old man with 5.6 cm juxtarenal abdominal aortic aneurysm who presented with multiple comorbidities. The patient had a single left kidney. A custom-made, single fenestrated stent graft was implanted successfully. The one-month follow-up showed a patent left renal fenestration without evidence of any endoleaks. Four months after the operation the patient was admitted with acute uremia. Imaging studies revealed an occluded left renal stent, which was successfully reopened. The second case was a 71-year-old man with 8.0 cm juxtarenal aneurysm. He presented with severe coronary artery disease among other multiple comorbidities in his medical history. He was successfully treated with a 3-vessel custom-made fenestrated stent graft to the renal and the superior mesenteric arteries. The one-month CT imaging revealed patent fenestrations without endoleaks. DISCUSSION: With the development of fenestrated endograft technology, complex aneurysms with visceral artery involvement can be treated with complete endovascular approaches. The first fenestrated endovascular case in Hungary was treated in the Heart and Vascular Center of Semmelweis University, Budapest. The short and middle-term results are offering improved clinical results when compared with conventional surgery, but the long-term outcomes are difficult to ascertain from the current published series.