Endovascular abdominal aortic repair and concomitant intraprocedural endovascular interventions: Our single-center experience

Özet

Objectives: The aim of this study was to retrospectively evaluate patients who underwent endovascular treatment due to abdominal aortic aneurysms (AAAs) and ruptured AAAs at our center, especially in terms of secondary interventions performed during endovascular treatment and to compare the obtained data with the current literature. Patients and methods: A total of 137 patients underwent endovascular stent graft implantation due to AAA and ruptured AAA at our center, between 2004-2012. Eighty-one patients whose preoperative CT scans could be obtained were recruited in the study. Demographic data, preoperative aneurysm diameters, aneurysm neck lengths, neck angles, success rate for stent placement, perioperative mortality rate (<30 days), aneurysm-related mortality rate (<30 days), secondary intraprocedural endovascular interventions, and time of discharge from the hospital were evaluated. Results: Seventy-three of the patients were male and eight were female, and their ages were between 51-89 (mean: 70.1±8.8) years. The largest aneurysm diameters varied between 53 and 110 (mean: 63.8±12.9) mm. Aneurysm neck lengths varied between 0-60 (mean: 24.1±12.4) mm. The angle between aneurysm neck and suprarenal aorta was between 17-90 (mean: 34.9±15.9) degrees. Of our patients, 75 were treated due to AAA and 6 were treated due to ruptured AAA. The mean time of discharge from the hospital was 4.54±3.6 (range, 2-24) days for patients treated electively. The mean time of discharge from the hospital was 10.2±8.7 (range, 3-25) days for the six patients operated due to ruptured AAA. Perioperative mortality (<30 days) was not detected in any of the patients treated electively and perioperative mortality rate (<30 days) in ruptured AAA group was 16.6%. Aneurysm-related mortality (<30 days) was not detected in any of the 81 patients. Although secondary endovascular interventions were required in 14 of 81 patients (17.2%) during the procedure, stent graft placement success rate was found to be 100%. Conclusion: Our study results demonstrate that endovascular treatment is a method that may be performed safely with a high technical success rate, and decreases perioperative mortality rate, aneurysm-related mortality rate, and time to discharge. Concomitant interventions required during the procedure suggest that endovascular treatment must be performed by experienced teams with sufficient knowledge